In recent years, knowledge about the cell biology of the cholangiocytes and the function of the bile ducts has increased considerably. Their role in liver diseases is increasingly recognized. As a consequence, important progress has been made not only in the pathogenesis and pathophysiology but also in the diagnosis and treatment of biliary liver diseases. This book, the proceedings of the Falk Symposium 107 on Diseases of the Liver and the Bile Ducts - New Aspects and Clinical Implications', held in Prague, Czech Republic, on April 30-May 2, 1998, brings together scientists and clinicians to highlight the most recent advances in molecular biology, physiology, diagnosis and therapy of diseases of the biliary system. World experts cover a broad spectrum of topics from genetic tests to endoscopy and from medical treatment to liver transplantation.

Although cell turnover in normal adult liver is extremely low, hepatic tissue is notorious for its almost infinite capacity to regenerate in cases of viral, toxic or traumatic damage. Hepatocellular carcinoma is one of the most frequent malignancies worldwide and causes more than a million deaths per year. The mechanisms governing normal proliferation and malignant transformation of liver cells are of utmost interest for the understanding of regeneration and hepatocarcinogenesis and for the development of new therapeutic strategies. Therefore, the International Falk Workshop held in Halle, Germany, on January 29-30 1998, focused on the issues of normal and malignant liver cell growth. Knowledge in this area of research has expanded rapidly during recent years. This book of proceedings summarizes the latest advances both in basic science and clinical research. Stimulating discussion set the basis for the development of new strategies in diagnosis and treatment of hepatocellular carcinoma and for the manipulation of regeneration in cases of acute or chronic loss of functional liver tissue.

The Liver in Biology and Disease was conceived as a sequel in the series "Principles of Medical Biology," whose general aim continues to be the integration of human biology and molecular cell biology into modern molecular medicine. It is a volume molded by the Information Revolution which few will deny has forced the teaching faculties in our medical schools to curtail and prune the teaching load and focus on fundamentals and principles. With this intention in mind, a volume of this nature takes into account the close dependence of progress in the medical sciences on bioinformatics (gene and protein analysis) or more precisely, computational biology and of course, the Internet. In general, it follows the pattern of its predecessors.
*Chapters are illustrated with numerous figures and references are current
*Clear, concise and accurate text about a large number of liver diseases
*Describes the liver's histology, biochemistry, and pathology in molecular terms

At the Mie International Symposium held in Japan in April 1994, leading scientists reviewed recent advances in the understanding of the contractile mechanism in smooth muscle. The present volume collects the papers presented at the symposium, summarizing the latest advances in smooth muscle function and emphasizing important components of the contraction-relaxation cycle. Topics include a discussion of the smooth muscle cell membrane, with emphasis on its ion channels; the regulation of cytosolic Ca2+ levels and the relationship to force in smooth muscle; aspects of the two key regulatory enzymes involved with myosin phosphorylation-dephosphorylation; the molecular basis for pharmacomechanical coupling in smooth muscle; developments in the basic contractile mechanisms involving the crossbridge cycle of tonic and phasic muscle; the role of myosin light chains; and many others. The approach is broad and presents contemporary opinions in pharmacology, physiology, and biochemistry as they relate to smooth muscle function. The book will appeal not only to those working in these disciplines, but to vascular clinicians, obstetric-gynecological physicians, and gastroenterologists as well.

The condition of prolonged obstructive jaundice with patent bile ducts was first described in 1851 by Addison and Gull of Guy's Hospital, London. The term primary biliary cirrhosis (PBC) was defined in 1950 by Ahrens and colleagues of the Rockefeller Institute, New York. The condition was considered rare but this changed in 1965 with the discovery of a definitive diagnostic serum mitochondrial antibody test and the recognition that a raised serum alkaline phosphatase value, often discovered incidentally, could be a diagnostic pointer. If the diagnosis is made earlier, the end stages are rarely reached as death is replaced by liver transplantation. On November 6th 1997, in Chicago, an International Faculty discussed in depth the clinical features, pathogenesis and treatment of PBC, no longer considered a rare disease. The course of PBC is long, but some 18 years after the discovery of a positive mitochondrial antibody test in a symptom free patient with normal serum biochemistry, 83% will have developed abnormal tests and 76% will be symptomatic. Identification of those who will progress rapidly is difficult. The serum antimitochondrial profile may be useful but this is a very specialist technique. Mathematical prognostic models are useful in therapeutic trials and in the selection and timing of patients for liver transplantation but have limited value in individual patients. An increasing serum bilirubin level remains the most important indicator of rapid progression. Its value however can be negated by the use of ursodeoxycholic acid which has a bilirubin-lowering effect."

As a major transplantation center, the University of Pittsburgh has conducted more than 300 liver transplants. Because the problems faced by an institution contemplating the initiation of such an organ transplantation program are many, unique, and often unexpected, the university has been beseiged by requests from other physicians and hospitals for training and advice. This book represents much of the accumulated experience on hepatic transplantation to date.

Hepatobiliary and pancreatic surgery is a relatively new specialty and the vast majority of patients present initially outside tertiary referral centres. Many conditions such as gallstones, acute and chronic pancreatitis, obstructive jaundice and malignancies of the liver, biliary tract and pancreas are still managed outside specialist centres or are not suitable for referral. Many general surgeons continue to manage these problems and in some parts of the world the geography and distances involved makes referral for specialist care difficult or impossible. The relative scarcity of specialist centres for the management of these difficult conditions also means that the majority of trainees do not get sufficient exposure prior their definitive appointment to equip them with the tools needed to confidently manage many of the problems they may face.
Operative Solutions in Hepatobiliary and Pancreatic Surgery combines clearly written, practical text with over 200 illustrations and numerous flow charts which take the reader through the management of all the commonly encountered hepatobiliary and pancreatic pathologies and procedures. All aspects of hepatobiliary and pancreatic surgery are discussed in a clear and consistent style, while the flow charts are designed to be modified by the reader to adapt them to local practice and the facilities and expertise available. This book is invaluable for the senior trainee or newly appointed specialist who requires clear, practical advice on how to manage the wide range of problems that present to surgeons outside specialist centres.

Hepatic sinusoidal cells such as sinusoidal endothelial cells, Kupffer cells, hepatic stellate cells, and pit cells play an important role in hemodynamic and metabolic function and are involved in various liver diseases. The frequent involvement of sinusoidal cells in pathologic conditions is explained by the diverse actions of those cells, an understanding of which is essential to clinicians. Generously illustrated, this volume presents results of recent studies on hepatic sinusoidal cells in liver diseases, with an introduction to the structure and function of the various types of sinusoidal cells. The in-depth focus of the book is on the role of hepatic sinusoidal cells in relation to liver injury and regeneration, hepatic sinusoidal microcirculation, alcoholic liver diseases, hepatic fibrosis, liver tumor, liver transplantation, cholestasis, and congenital lipidosis, thus providing a valuable reference source for practitioners and researchers.

This book presents state-of-the-art information summarizing the current understanding of a range of liver diseases, and reviews some key diagnostic and therapeutic advances. The book is a collection of selected clinical and scientific topics divided into two volumes, each divided into two sections. The first volume treats the cellular, biochemical and immunological mechanisms underlying liver diseases; the second focuses on clinical liver disease pathophysiology and related diagnostics and therapeutic insights. It is hoped that the target readers - hepatologists, clinicians, researchers and academicians - will be exposed to new ideas, and subjects beyond their own scientific disciplines. In addition, students and all those who wish to enlarge their knowledge of advances in the field of liver diseases will find this book a good source of information.

In recent years there have been huge advances in the understanding of the genetic and molecular basis of the fibrocystic diseases. This volume provides a thorough review of fibrocyctic diseases that affect the liver. It contains in-depth discussions of the genetics, molecular biology, pathogenesis, histology, clinical presentations, complications of, treatment, and prognosis of the conditions affecting children and adults, and hence will be the gold-standard reference for these conditions. In addition, the histological features that distinguish these conditions from other potentially fibrosing hepatopathies are illustrated. Conditions with syndromic features involving the kidney or other organ systems are also reviewed. Thorough review of the clinical phenotypes, their presentations, treatment, potential complications of, and prognosis is discussed.

Fibrocystic Diseases of the Liver will be an invaluable resource for hepatologists, gastroenterologists, nephrologists, and hepatic surgeons who care for children and adults with liver disease, as well as basic scientists in molecular genetics, hepatobiliary pathophysiology, hepatology and nephrology.

More than 2 million people in Japan have chronic hepatitis C and many of them will lose their lives to liver cirrhosis or complications of hepatocellular carcinoma. Hepatitis C virus-related diseases are a serious concern both in developing countries and in Japan and the United States, where the number of patients is also in the millions. Therapeutic modalities recently developed in Japan, including interferon therapy and nutritional supportive therapy, are gaining worldwide acceptance. At this critical juncture, HCV and Related Liver Diseases presents new information on etiology, pathology, diagnosis, and therapy. Viral hepatitis was the theme of the Yamaguchi Symposium on Liver Disease, meeting in December 1998 and attended by leading hepatologists and virologists. Collected in this volume are the papers from the symposium, providing a valuable resource for hepatologists, gastroenterologists, and others working to understand and treat viral hepatitis.

This book is written as a reference and guidebook for practicing surgeons, gastroenterologists, and interventional radiologists with an interest in hepatobiliary diseases. It presents a strategy to enhance surgeons practice and the care of patients.

In this issue of Clinics in Liver Disease, guest editor Dr. David Bernstein brings his considerable expertise to the topic of The Liver and Renal Disease. The presence of liver disease in patients with chronic renal disease makes the management of both conditions more challenging. In this issue, top experts in the field address many aspects of the treatment and management of these co-existing conditions. Contains 13 relevant, practice-oriented topics including hyponatremia in cirrhosis; pathophysiology of hepatorenal syndrome; definitions, diagnosis, and management of hepatorenal syndrome; renal replacement therapy in patients with acute liver failure and end-stage cirrhosis awaiting liver transplant; simultaneous liver/kidney transplantation; and more. Provides in-depth clinical reviews on the liver and renal disease, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

This book is the proceedings of Falk Symposium 157, entitled ?Chronic Hepatitis: Metabolic, Cholestatic, Viral and Autoimmune?, held in Freiburg, Germany, on 10--11 October 2006 (one of three symposia during the XIII Falk Liver Week 2006). It provides up-to-date information on new developments in the field of chronic hepatitis and its various entities. In recent decades we have learned how heterogeneous the clinical entity of chronic hepatitis has become. The liver, as the central organ of metabolism and detoxification, is more than ever a target of disease processes evolving from the spread of obesity in the western world. Apart from nonalcoholic steatohepatitis (NASH), alcoholic liver disease is still the most prevalent liver disease in the west...

The therapeutic handling of autoimmune liver disease is limited because basic mechanistic insights into immunologically mediated pathophysiology have not yet been translated into standard pharmacological treatments. A future expansion of the incidence of autoimmune liver diseases is anticipated because of growing rates of exposure to an increased variety of xenobiotics of dietary, pharmaceutical or environmental origin. This book, the proceedings of an International Falk Workshop held in Konstanz, Germany, January 23-24, 1997, aims to share front-line thinking among immunologists, biochemists, pharmacologists and clinicians in order to better understand the aetiology of this liver disease and its relation to extra-hepatic factors.

Recent advances in surgical procedures for the management of focal liver diseases have greatly increased the demand for diagnostic accuracy. So far these demands have been only partially met by further technical developments such as colour coded duplex sonography, spiral CT and marked improvements in magnetic resonance imaging. It is becoming increasingly clear that liver specific contrast media are essential for utilizing these technical developments to their fullest advantage in patient care. Against this background, a workshop was held to explore the current methods of diagnostic imaging of the liver and to try and establish a profile for the future liver specific contrast media. The pathologist's introductory and general overview is followed by chapters on the individual imaging procedures such as ultrasound, CT and MRI, so that each of the three is given the attention it deserves. The book will be of interest to radiologists from the various disciplines, and also those who plan and perform therapies, particularly surgeons and internists.

Since the discovery of superoxide dismutase more than three decades ago, there has been rapid growth in the knowledge of oxidative stress and disease. This volume containing the proceedings of the 13th Yamaguchi Symposium on Liver Disease includes discussion of the direct cellular effects of hepatitis C virus (HCV) proteins on hepatocytes and reviews evidence that oxidative stress caused primarily by the HCV core protein plays a key role in disease pathogenesis. Also included are chapters on new aspects of oxidative stress and liver disease such as carbon monoxide as a regulator of liver microcirculation, hepatic iron accumulation and the incidence of hepatocellular carcinoma, and oxidative stress in the absence of inflammation in hepatocarcinogenesis. This collection of papers from the Yamaguchi Symposium creates a valuable reference resource for physicians and hepatologists.

This book focusses on the latest results related to the field of bile acids as signaling molecules and describes how these receptors have become a major pharmacological target. It covers all major areas of research in this field, from genetics, chemistry, in silico modeling, molecular biology to clinical applications, offering a cross-country view of the functional role of bile acids as signaling molecules, virtually acting on all major areas of metabolism. While FXR and GPBAR1 are essential bile acid sensors that integrate the de novo bile acid synthesis with intestinal microbiota and liver metabolism, in a broader sense, BARs play a pathogenic role in the development of common human alignments including liver, intestinal and metabolic disorders, such as steatosis (NAFLD) and steato-hepatitis (NASH), diabetes, obesity and atherosclerosis.

The liver is of central importance to the entire organism due to its diverse functions in metabolism, its ability to detoxify and excrete, the hepatic formation and inactivation of mediators, and its involvement in non-specific defence mechanisms. Thus, extrahepatic manifestations of liver disease are often decisive for the disease course. In the last few years, knowledge about interaction between the liver and other organs or systems - e.g. kidneys, GI tract, skeleton, endocrine, haematopoietic and nervous sytems - has increased considerably. Thus many extrahepatic manifestations of liver disease can now be better understood and are more accessible to diagnosis and therapy. The IXth International Congress on Liver Diseases brought together experts from around the world to give information on new developments in this field which are important both for research and clinical work. These proceedings will therefore be required reading for all researchers and clinicians dealing with effectsof liver diseases on the entire organism.

At no other time in human existence has there been so many environmental changes. Over 87,000 chemicals are now commercially available in the U.S., almost all of which have not been tested for safety, particularly in young children and the growing fetus.The number and quantity of chemicals has continued to increase since World War II-and so too has the incidence of many chronic health problems, such as Type 2 Diabetes, obesity, thyroid disease, asthma, allergy, autoimmune disease, autism, ADHD, and several cancers. Many studies have revealed that exposure to chemicals and radiation in our everyday environment may increase risk for these conditions. Integrative Environmental Medicine examines the history and changing landscape of our environment in the U.S. and shares up-to-date research and information on ways to reduce exposures and reduce health risks. This text explores the unique properties of many chemicals and their ability to deceive the human body's normal workings, affecting everything from thyroid and autoimmune disease risk, to cancer development, to developmental issues in children, and even the development of diabetes and weight gain through gut bacteria manipulation. We discuss topics of improving regulations and appropriate testing for chemicals, remediation of environmental catastrophes, and designing healthier products for the future. Finally, we discuss best practices for clinicians to ascertain exposure history and teach patients how to avoid harmful exposures and help their body eliminate contaminates through better dietary and lifestyle practices. Throughout this book, we share vetted, practical resources and tools-including websites, phone apps, physician and patient hand-outs-to help healthcare practitioners facilitate healthier choices for themselves and their patients. This text is unique in that it offers tangible, practical information that can easily be integrated into the daily work flow of patient clinical care; websites, phone apps, physician and patient handouts and printable lists.