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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Together with Consulting Editor Dr. Alan Buchman, Drs. Arun J. Sanyal and Mohammad Siddiqui have put together a comprehensive issue devoted to fatty liver disease for the gastroenterologist. Expert authors have contributed clinical review articles on the following topics: Burden of disease due to NAFLD; Genetic risk factors and disease modifiers of NASH; How to identify the patient with NASH who will progress to cirrhosis; Similarities and Differences between cirrhosis due to NASH versus other etiologies; Impications of NASH as the etiology of end stage liver disease prior to and after liver transplantation; Why do lifestyle recommendations fail in most patients; Rational nutritional therapeutics for NAFLD; Recruitment and retention strategies in long-term trials for NASH; Managing extrahepatic comorbidities in NAFLD; The current status of noninvasive tools for the assessment of NAFLD; and Pharmacological Treatment strategies for NASH. Readers will come away with the information they need to improve outcomes in patients with fatty liver disease.

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.

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.

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.

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. 

Studies on Hepatitis Viruses: Life Cycle, Structure, Functions, and Inhibition presents the latest on this systemic infection that predominantly affects the liver with inflammation that can be acute or chronic. Hepatitis viruses have been the subject of intense study in the last twenty years, with a wealth of information related to their lifecycle, structure, functions and inhibition being presented. This book compiles the most important developments and research, giving users a very useful guide on this evolving area of virology and medicinal chemistry.

Stem Cells and Cancer in Hepatology: From the Essentials to Application offers basic scientists and clinicians in the fields of stem cells, hepatology and oncology an overview of the interaction between liver biology, stem cells and cancer. It discusses how the liver performs regeneration and repair, the role stem cells play in these processes, and the mechanisms by which liver cancers are initiated and developed. As the field of stem cells and cancer stem cells in hepatology is new and dynamic, thus making it difficult for researchers and clinicians to understand the most relevant historic and novel studies, this volume addresses that challenge.

Brain Tryptophan Perturbation in Hepatic Encephalopathy: Implications for Effects by Neuropsychoactive Drugs in Clinical Practice; F. Bengtsson, et al. Hepatic Encephalopathy in Acute Liver Failure: Role of the Glutamate System; A. Michalak, et al. Glutamate and Muscarinic Receptors in the Molecular Mechanisms of Acute Ammonia Toxicity and of Its Prevention; M.D. Minana, et al. Studies on the Pharmacological Properties of Oxindole (2-Hydroxyindole) and 5-Hydroxyindole: Are They Involved in Hepatic Encephalopathy?; F. Moroni, et al. The Involvement of Ammonia with the Mechanisms That Enhance GABA-ergic Neurotransmission in Hepatic Failure; E.A. Jones, A.S. Basile. Direct Enhancement of GABA-ergic Neurotransmission by Ammonia; J.-H. Ha, et al. The Peripheral Benzodiazepine Receptor and Neurosteroids in Hepatic Encephalopathy; M.D. Norenberg, et al. Ornithine Aminotransferase as a Therapeutic Target in Hyperammonemias; N. Seiler. Sparse-Fur (spf) Mouse as a Model of Hyperammonemia: Alterations in the Neurotransmitter Systems; I.A. Qureshi, K.V.R. Rao. Abnormal Gene Expression Causing Hyperammonemia in Carnitine-Deficient Juvenile Visceral Steatosis (JVS) Mice; T. Saheki, et al. 7 Additional Articles. Index.

This book, the proceedings of Falk Symposium 163 Chronic Inflammation of Liver and Gut, held in Hangzhou, P.R. China, on March 14--15, 2008, presents the most recent progress in chronic inflammatory diseases of liver and gut. It focusses on molecular understanding, the therapeutic state of the art and future options of treatment.

The first part of the book concentrates on basic and clinical aspects of IBD. Chapters demonstrate the role of the immune system, genetic factors and the intestinal microflora in IBD, and give an evidence-based update on the current diagnostic and therapeutic options and present future perspectives for the management of IBD. The second part is devoted to chronic liver diseases with particular focus on the liver as an immune organ, treatment strategies of viral hepatitis and liver fibrogenesis. The final part deals with basic and clinical aspects of liver cirrhosis, hepatocellular carcinoma and liver transplantation. The book concludes with an outlook on therapeutic options of hepatic stem cells. Throughout, international experts from the USA, the People s Republic of China and Europe contribute their experience in different aspects of the mechanisms and management of chronic inflammatory diseases of liver and gut. "

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.

Hepatitis C in Developing Countries: Current and Future Challenges explores the current state of HCV in several countries, including Africa, Asia and South America. It maintains a dedicated focus on the epidemiology, clinical patterns, virologic diversity, coinfections, natural history and progression, complications, and response to standard of care (SOC) pegylated interferon and ribavirin therapy of HCV with recommendations specific to middle and low income countries. Readers will find detailed information on the burden of HCV infection from a global health and economic perspective, along with data from multicenter trials on DAAs that have enrolled patients infected with HCV non-genotype 1.

Cirrhosis from hepatitis C (HCV) is now the most common indication for liver transplant (LT) in the U.S., but between 2004 and 2013, new LT listings for NASH increased by 170%. Unfortunately, fibrosis progression leading to cirrhosis, liver cancer, and liver decompensation continues to occur after transplantation. Once cirrhosis and decompensation are evident, patient survival is poor and repeat LT is considered to improve outcomes. Therefore, the never-ending thirst for new approaches in the management of patients pre- and post-transplant has led to a very promising future in transplantation, thought there is much to learn to achieve better patient outcomes. This issue of Clinics in Liver Disease addresses the core areas to achieve better patient outcomes, with articles devoted to coagulopathy before liver transplant, challenges in renal failure before LT, LT for acute alcoholic hepatitis, LT in the pregnant patient, bariatric surgery and LT,and MELD Scores in prioritization of LT, to name a few. Readers will place a high value on the current state of liver transplantation in this issue.

Dr. Younossi is a highly-esteemed expert in Hepatitis C Virus (HCV), and for the first time in Clinics in Liver Disease, he has compiled articles that specifically address the extrahepatic manifestation of HCV. Articles are specifically devoted to the following topics: Hepatitis C: A Systemic Disease; Rheumatologic Manifestations of HCV; Cardiovascular Manifestations on HCV; Metabolic Manifestations of HCV (DM, Dyslipidemia); Renal Manifestations of HCV; Lymphoproliferative Disorders Associated with HCV; Depression and HCV; Neurologic Manifestations of HCV; Non-HCC Malignancies in HCV; Dermatologic Manifestations of HCV; Fatigue and Patient-reported Outcomes in HCV; Economic Burden of HCV; and Endocrine Manifestations of HCV (non-dabetes). The thorough coverage of systemic issues will give clinicians the information they need to effectively manage the HCV patient with other health issues.

Dr. Lefkowitch has created a primer on liver pathology for the gastroenterologist that provides depth of clinical coverage in an area not typically covered in depth for gastroenterologists. This issue will provide state-of-the-art reviews in the areas of NAFLD, liver biopsy, liver pathology, hepatitis, and genomics. Articles are specifically devoted to IgG4-related disease and the liver; current concepts in pediatric NAFLD; evaluation of the pediatric liver biopsy; hepatocellular adenomas: morphology and genomics; drug-induced liver injury: the hepatic pathologist's approach; liver pathology in alpha-1-antitrypsin deficiency; immunohistochemistry in the diagnosis of hepatocellular carcinoma; HIV infection, antiretroviral therapy and liver pathology; autoimmune hepatitis overlap syndromes and liver pathology; current perspectives on the pathology of hepatocellular carcinoma and its variants; hepatitis E virus and the liver: clinical settings and liver pathology; hepatic progenitor cells; and cholangiocarcinoma: current genomics and pathology, to name a few.

Control of Urea Synthesis and Ammonia Detoxification.- Brain Metabolism in Hepatic Encephalopathy and Hyperammonemia.- Ammonia Metabolism in Mammals: Interorgan Relationship.- Clinical Manifestations and Therapy of Hepatic Encephalopathy.- Nutritional Considerations in Patients with Hepatic Failure.- Do Benzodiazepine Ligands Contribute to Hepatic Encephalopathy?.- Effects of Hyperammonemia on Neuronal Function: NH4+, IPSP Cl-Extrusion.- Activation of NMDA Receptor Mediates the Toxicity of Ammonia and the Effects of Ammonia on the Microtubule-Associated Protein MAP-2.- Modulation of the Exocytotic Release of Neurotransmitter Glutamate by Protein Kinase C.- Controls of Cerebral Protein Breakdown.- Two Different Families of NMDA Receptors in Mammalian Brain: Physiological Function and Role in Neuronal Development and Degeneration.- Glanglioside GM1 and its Semisynthetic Lysogangliosides Reduce Glutamate Neurotoxicity by a Novel Mechanism.- Contributors.

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).

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.

The only resource of its kind, this is a concise, practical guide to GI and Liver Disease that delivers current information on diagnosing, managing, and treating common GI and liver disorders, along with liver transplant guidelines. Written for nurses, nurse practitioners, and physician assistants in varied specialties, it fills a gap in information needed by primary and acute care professionals who are the chief caretakers for GI and liver patients. This guide delivers recent important treatment advances that have revolutionized GI and liver care, and provides guidance for seeking expert advice or urgent/emergent care for more complex cases. An outstanding feature is the prominently displayed Fast Facts in a Nutshell highlighting key takeaway points at a glance. The resource reviews common GI symptoms and disorders from irritable bowel disorders (including key differences between Crohn's disease and ulcerative colitis) to gallstones and GERD. A section on liver disease describes essential liver functions, reviews liver function tests, and addresses commonly and less commonly seen liver disease diagnoses. Complications of cirrhosis are examined to assure prompt recognition of these potentially deadly symptoms. Additionally, the book addresses liver transplantation with comprehensive attention to the evaluation process, organ donation/allocation, and post-transplant care for donor and recipient alike. Each chapter includes an overview, significant laboratory or imaging findings, treatment options, expected outcomes, and "Fast Facts in a Nutshell. An additional feature is the provision of IDC-10 codes for billing and reimbursement. Key Features: Provides speedy access to current information on diagnosing managing, and treating common GI and liver disorders for front-line professionals Includes comprehensive review of the liver, abnormal liver function tests (LFTs), and transplantation Reflects up-to date information on the latest treatment guidelines for gastrointestinal and liver disease, including celiac disease and Hepatitis C Addresses common gastrointestinal diseases and guidelines for treatment as outlined by ACG Discusses current liver disease management and guidelines for treatment as outlined by AASLD

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.

Hepatobiliary medicine has seen major recent scientific advances in viral hepatitis, haemochromatosis and autoimmune liver/disease helped by imaging advances in MRI and CT. This volume of some 200 cases by an internationally renowned author team, covers the whole spectrum of liver disease, focusing on the clinical photos, imaging, charts and graphs. The problem-oriented, randomized self-assessment format, lends itself to revision and continuing professional development. The book will appeal particularly to young doctors preparing for membership and board examinations.

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)