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.

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.

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.

Dr. Lefkowitch is one the most well known experts on liver pathology and has updated the topic since it last published over 5 years ago. Important topics updated include benign liver tumor, vascular disorders of the liver, autoimmune hepatitis, and non-alcoholic fatty liver disease. Special emphasis is given to articles devoted to immunochemistry in liver tumors, hepatic granulomas, and diagnostic pitfalls in liver transplantation.

A recent Institute of Medicine report has concluded that "there is a lack of knowledge and awareness about chronic viral hepatitis on the part of health-care and social-service providers, as well as among at-risk populations, members of the public, and policy-makers. Due to the insufficient understanding about the extent and seriousness of this public-health problem, inadequate public resources are being allocated to prevention, control, and surveillance programs." It is with these concerns in mind that Dr. Tsai assembled a group of experts in this field to present their expertise in such a level, where the practicing clinicians who deal with this disease in their daily practice can understand thereby implement this knowledge into their own practice. Dr. Brian McMahon discusses the natural history of chronic hepatitis B with his vast knowledge and experience working with the high endemic population of Inuit in Alaska; Drs. Marc Ghany and Ed provide a very easy-to-understand description of HBV virology; Dr. Kyon-Mi Chang contributes an article on HBV immunology, which is the least understood area of this disease but has the most potential to improve our knowledge in the management of chronic hepatitis B; Dr. Anna Lok provides an authoritative review on the current issues and controversies of treatment of chronic hepatitis B; Dr. Stephen Locarnini, who has extensive experience in anti-viral resistance and its management, presents important issues in the usage of currently available anti-viral oral agents; Dr. Myron Tong discusses the current understanding of HBV carcinogenesis and updates HCC surveillance and treatment-- the most dreadful outcome of this disease; Dr. Paul Martin discusses management of end- stage chronic hepatitis B -anti-viral therapy, montherapy vs combo.therapy, choice of agent, when to start therapy and post-transplant patients including duration of HBIG therapy, HBcAb(+)only recipient) and Occult HBV infection; Dr. Tram Tran discuss the treatment in reproductive women, during pregnancy, and prevention of vertical transmission in third trimester with antiviral agents-- an area with significant lack of good clinical evidence; Dr. Steve Han discuss management of patients with acute hepatitis B, co-infection with HDV/HCV/HIV, pre-immuno-suppressive therapy, and management of renal and heart transplant patients with HBV infection; Dr. Mei Huei Chang discusses Taiwanese success in implementing universal vaccination leading to a remarkable reduction in both prevalence of chronic hepatitis B and incidence of hepatocellular carcinoma; and finally Drs. Michelle Lai and Yun Fan Liaw provide a rundown of what we have accomplished and the hope for the future in our fight to control this disease.

Gastrointestinal endoscopy plays an essential role in the management of patients with liver disease. This issue reviews the standard of care in the endoscopic management of portal hypertension and biliary disease before and after liver transplantation. A thorough knowledge of the available endoscopic diagnostic and therapeutic methods is essential for the practicing hepatologist. Emphasis is placed on recent advances in imaging techniques such as the application of capsule endoscopy and endoscopic ultrasound in the evaluation of portal hypertension and recent advances in cholangioscopy and biliary tissue sampling. Additionally new information regarding the endoscopic management of esophageal and gastric varices is reviewed. Finally, the current role of ERCP in the diagnosis and staging of cholangiocarcinoma before liver transplantation and the endoscopic management of biliary complications after liver transplantation is discussed.

This issue offers the latest information regarding the transmission of hepatitis viruses in various healthcare settings.? It delves with a very timely and interesting patient safety subject that specifically targets healthcare professionals, gastroenterologists, hepatologists, oncologists, dentists and all healthcare workers to adopt and share a variety of best practices to prevent this adverse event. Well known faculty in liver disease, infection control as well as a medical practice in a legal setting have been assembled to produce a comprehensive and concise edition that highlights the latest information regarding hepatitis B and C transmission in healthcare.? It aims to provide an overview on the molecular epidemiology, the outbreak reports, the transmission in hemodialysis, endoscopy, dental, oncology, management, legal aspects and the infection prevention measures to reduce the risk of needless exposure of patients to these blood borne pathogens.

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.

This issue presents the views of internationally renowned experts on current findings concerning the epidemiology, natural history, diagnosis, pathogenesis, and treatment of non-alcoholic steatohepatitis. Articles are included on bariatric surgery, liver transplantation, cytokines and apoptosis, as well as insulin resistence and lipotoxicity, to name a few. The Guest Editor himself ends the issue with an article giving his overall perspective on the current clinical management of NASH and future directions.

This issue of the Medical Clinics of North America brings the practicing clinician up to date on best practices of caring for the cirrhotic patient. Topics covered include diagnosis and epidemiology of cirrhosis; ascites: diagnosis and management; encephalopathy: pathophysiology and emerging therapies; portal hypertensive bleeding; renal failure: differential diagnosis and management; pulmonary complications; hepatocellular carcinoma: current state of treatment; preventative health issues; pre-operative risk assessment; and liver transplantation: from Child's to MELD.

The Guest Editor presents state-of-the-art articles devoted to therapies for treatment of HCV. The novel therapies addressed in this issue include interferons, viral kinetics and anti-viral resistence, anti-fibrotics, immunotherapeutics, hepatoprotectants and caspace inhibitors, and cyclosporine analogues, to name a few.

Often the hepatologist sees patients in consultation, and this issue focuses on how to deal with diagnosing, treating, and managing patients in the hospital on a consultation basis. The Guest Editor has assembled top experts to present articles on the asymptomatic outpatient with abnormal LFTs, surgery in the patient with liver disease, issues in long-term care of liver transplant recipients, management of autoimmune cholestatic liver disease, and current status of hepatitis vaccination and prophylaxis, to name a few.

In this issue, the Guest Editors have focused on recent advances in liver disease related to disturbances in hemostasis and coagulation. The work emphasizes the multifaceted aspects of coagulation disorders in liver disease from hypo-coagulable to hyper-coagulable states and the limitations of conventional tests such as the INR to shed light on relative bleeding risk or on underlying pathophysiology in a given patient. Articles are written by leaders in the field from multiple disciplines and from around the world. In each article, the state of the art is discussed along with its limitations. The issue sheds light on recent advances, explores areas of controversy, and thus, addresses the need of combined clinical and laboratory investigation.

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.

Chronic hepatitis B and C affect 520 million people worldwide, and are a major cause of chronic liver disease and of mortality, despite the efficacy of the vaccine. Hepatitis B and C: Management and Treatment second edition provides a practical explanation of the natural history and management of the disease, and examines the benefits of the most recent drugs, and their effects, whether used in isolation or as part of a combination therapy. This second edition expands the coverage of treatment of various difficult-to-treat patients and will be a welcome guide to the physician in both clinical decision-making and in explaining the benefits and side-effects to the patient.

A concise, practical guide to the diagnosis and treatment of liver disease. Authoritative and practical, this important new book not only spells out the advantages and limitations of the latest diagnostic tests, but also provides numerous algorithms for evaluating patients and treating the liver problems commonly encountered by primary care physicians. Here, too, the reader will find described the nuances of serological tests for the detection of viral infections and how best to use invasive and noninvasive radiological tests in specific circumstances. Common complications are fully discussed and detailed practical information is given on how to recognize the patient's immediate problems and deal with them effectively. This book's numerous diagrams, clinical "pearls," and cost comparisons will clarify the often complex and bewildering array of conditions associated with liver disease and make it a definitive and indispensable guide for primary care physicians, medical students, and residents.

"Frontiers in Viral Hepatitis" provides a compilation of the research from over 40 key opinion leaders in the field of Hepatitis. The book focuses on the latest advances in the search for new, more effective therapeutic options and related topics in viral hepatitis. These include regulatory issues, epidemiology, and emerging viruses; immunology and vaccines; viral hepatitis B and C infections in children; genetics pathology and viral diagnosis; cell systems and animal models; novel therapeutics for hepatitis B and C; resistance and therapeutic strategies in humans; and prevention and treatment options for hepatocellular carcinoma.

The breadth of information published in this volume provides insight into current prevention and treatment options. Recent advances in our understanding of the molecular biology, immunology and pathogenesis of hepatitis viruses have accelerated at a remarkable rate, offering a more comprehensive perspective on hepatitis.

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.

Contents:
Part 1. Specific Lesions 1. Alcoholic Fatty Liver Andrew J. Bathgate and Kenneth J. Simpson 2. Alcoholic Hepatitus H. Denk, K. Zatloukal and C. StumptnerIN 3. Fibrosis in Alcoholic Cirrhosis Samuel W. French Part 2. Direct and Indirect Consequences of Alcohol Metabolism 4. Genetics of Ethanol Metabolism and Alcoholic Liver Disease Paul Y. Kwo and David W. Crabb 5. Acetaldehyde Adducts: Role in Ethanol-Induced Liver Disease John Koskinas Part 3. Mechanisms of Damage 6. Free Radicals and Alcohol-Induced Liver Injury Emanuele Albano 7. Ethanol and the Hepatic Microcirculation Robert S. McCuskey 8. Cytokines and Alcohol Liver Disease F. Javier Laso, J. Ignacio Madruga Alberto Orfao 9. Adhesion Molecules and Chemokines in Alcoholic Liver Disease Neil C. Fisher and David H. Adams 10. Role of Endotoxin and Kupffer Cells as Triggers of Hypoxia-Reoxygenation in Alcoholic Liver Injury R.G. Thurman, B.U. Bradford, K.T. Knecht, Y. Iimuro, G.E. Arteel, M. Yin, H.D. Connor, C. Rivera, J.A. Raleigh, M.V. Frankenberg, Y. Adachi, D.T. Forman, D. Brenner, M. Kadiiska and R.P. Mason 11. Ethanol and Protein Turnover Elena Volpi 12. Insulin-Like Growth Factors: Clinical and Experimental Anthony J. Donaghy 13. Cellular Mechanisms of Liver Regeneration and the Effect of Alcohol Martin Phillips, Elika Kashef and Robin Hughes 14. Alcohol and Hepatocellular Carcinoma Stephen D. Ryder 15. Animal Models of Ethanol-Induced Liver Disease Harri A. Järveläinen and Kai O. Lindros Part 4. Epidemiology and Diagnosis 16. Epidemiology and Comparative Incidence of Alcohol-Induced Liver Disease John B. Saunders and Benedict M. Devereaux 17. Serum Diagnosis of Alcoholic Liver Disease and Markers of Ethanol Intake Onni Niemelä Part 5. Extrahepatic Effects 18. Extrahepatic Effects of Alcohol: An Overview Helen L. Reeves and Christopher P. Day 19. Endocrine System Christian Gluud 20. Cardiomyopathy and Skeletal Muscle Myopathy Alvaro Urbano-Márquez, Joaquim Fernández-Solà and Ramon Estruch 21. Cerebral Consequences of Alcoholic Liver Disease Roger F. Butterworth Part 6. Management 22. General Management of Alcoholic Liver Disease Martin Phillips and John O'Grady 23. The Role of the Psychiatrist in the Treatment of Alcoholic Liver Disease José Martínez-Raga and E. Jane Marshall 24. Pharmacological Treatment for Alcoholic Hepatitis and Cirrhosis: Present Practice and Future Strategies Philippe Mathurin and Thierry Poynard 25. Nutritional Support in Alcoholic Liver Disease: Practical Management and Future Strategies Angela Madden 26. Alcohol and Viral Hepatitis: Interactions and Management Albert Parés and Joan Caballería 27. Liver Transplantation in Alcoholic Liver Disease Stephen P. Pereira and Roger Williams

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 book builds on the success of previous editions, once again providing hepatologists the most current clinical guide on how to best treat the liver transplant recipient. With an international mix of experienced contributors, this new edition highlights initial indication and selection of the potential recipient, management of the donor organ, post-operative complications in the patient through to acute recovery, long-term follow-up, and continued health. This provides the user a complete guide to the correct clinical management of both the recipient and the donor organ through all stages of transplantation.

This second edition looks at the physiologic, biochemical, and morphologic characteristics of hepatotoxicity and includes an analysis of techniques in molecular biology and immunochemistry, among others contributing to the growth in understanding of the toxic events involved. It focuses on clinical characterization of chemical hepatotoxicity, microscopic characteristics of the mechanisms by which chemicals can produce liver injury and experimental models useful for the study of liver dysfunction.

Leading international virologists review the state-of-the-art in the biology, pathogenesis, and epidemiology of the hepatitis viruses. The authorities writing here examine the five well-recognized hepatitis viruses, A through E, and some of the newer agents, the so-called non- A-E hepatitis viruses. They also provide in-depth discussions of the biological nature of the viruses, the pathogenesis of the acute and chronic diseases they cause, the methods and ease with which they are transmitted, and their clinical signs and symptoms. Additional topics include diagnostic tests and routine blood screening, new vaccines, and the use of interferon and antiviral drugs. Viral Hepatitis: Diagnosis, Therapy, and Prevention provides the most comprehensive and up-to-date survey of the hepatitis viruses currently available

Zinc has an important role in human physiology due to its involvement in numerous enzymatic reactions and its other functions as part of hormones and structural proteins. As a consequence a wide variety of symptoms may occur in different states of zinc deficiency. Several diseases of the digestive tract can lead to zinc deficiency and consequently to deficiency symptoms. This book, the proceedings of an International Falk Workshop held in Freiburg, Germany, on 27 October 1996, aims at a dialogue between basic researchers and gastroenterologists in order to improve the understanding of the role of zinc in disorders of the digestive tract. Based on lectures on the role of zinc in cell biology, the pathophysiology of zinc deficiency and consequently the possibilities of zinc substitution in these disorders is discussed. It is hoped that this book will initiate fruitful discussions and collaborations leading to a better knowledge of the role of this trace element in gastroenterology.

Primary liver cancer is the third most deadly and fifth most common cancer worldwide (approximately 500,000 deaths annually), with a sharp increase of incidence in the United States in recent years. Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) are the major types of primary liver cancer. Risk factors include gender, hepatitis B virus (HBV), hepatitis C virus (HCV), cirrhosis, metabolism diseases, diabetes, obesity, toxins, excess alcohol consumption and smoking. Liver cancer arises most frequently in inflammatory livers with extensive oxidative stress due to viral hepatitis which causes over 80 per cent of HCC cases worldwide. Currently, survival remains dismal for most HCC and CC patients, largely due to the tumor's aggressiveness at the time of diagnosis and the lack of effective therapy.