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.

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 liver is the body's workhorse. It makes proteins and bile, processes fats, and detoxifies drugs and alcohol. The liver is a resilient organ, but it is susceptible to damage from a number of sources, including viral infections. Such infections cause inflammation of the liver, called hepatitis. This book is a comprehensive guide to hepatitis C, which affects about 3 percent of the world's population-3 to 4 million people in the United States alone. Some people with acute hepatitis C infection will be cured without any treatment, but when hepatitis C becomes chronic it may cause cirrhosis, liver cancer, and death. Hepatitis C is transmitted from an infected person to an uninfected person by sharing drug-injecting equipment, snorting cocaine, having sex, or getting a blood transfusion or organ transplant. It can be spread by getting a tattoo with unsterile equipment. In rare cases, women with hepatitis C transmit the virus to their infants. World-renowned gastroenterologist and liver specialist Dr Paul J Thuluvath provides detailed information about the disease and its diagnosis and management, including dramatically improved treatments that have recently emerged. Dr Thuluvath answers common and uncommon questions about hepatitis C and liver disease, including: How is hepatitis C spread? Who should be tested-and what tests diagnose hepatitis C and other liver diseases? What are the symptoms of acute liver disease? What are the symptoms and complications of chronic liver disease? What are the complications of cirrhosis (scarring of the liver)? How does hepatitis C affect other organs in the body? What treatment options are available, and what side effects might they have? How is early liver cancer diagnosed and treated? When is liver transplantation needed, and how does it work? Dr Thuluvath provides the latest information on new interferon-free regimens, which have shown a cure rate of more than 90 per cent in people with specific genotypes-and which avoid the distressing side effects of interferon therapy. He discusses hepatitis C in children as well as complementary and alternative medicine. Published while revolutionary changes are taking place in the treatment of hepatitis C, this authoritative guide will become the preferred reference for people with hepatitis C and their families.

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.

Practical, handy and succinct, this full colour pocketbook provides clear-cut clinical guidance to the main symptoms that infants and children commonly present with in both primary and secondary care. Clearly divided into specific sections covering the GI tract, liver and nutrition, Professor Kelly and her team discuss how best to investigate and manage specific clinical problems such as vomiting, abdominal pain, acute diarrhoea, constipation and jaundice using a highly clinical problem-orientated approach. They cover the management of important clinical problems such as chronic liver disease, ascites, malnutrition, obesity, coeliac disease and inflammatory bowel disease, and provide advice on nutritional problems in premature infants and children including weaning and food aversion. Key points, potential pitfalls, and management algorithms allow for rapid-reference, and link with the latest evidence, guidelines and protocols from ESPGHAN and NASPGHAN providing coverage of the major professional society recommendations for clinical practice. Brought to you by the experts, Practical Approach to Gastroenterology, Hepatology and Nutrition is the perfect accompaniment for trainees in gastroenterology, hepatology and pediatrics, as well as nutritionists, GI nurses and GPs.

Prometheus was punished by the supreme god Zeus for giving to mankind the Olympic fire with which they learned to think and feel. He was chained to a cliff in the Caucasus, where, to make matters worse, he was visited daily by an eagle who ate part of his liver. At night, however, his liver grew back. We now know that the liver can regenerate, but were the ancient Greeks aware of this quality? The myth of Prometheus has been a source of inspiration for many visual artists over the centuries. In this book, the medical history of the liver is traced through the ages through an examination of historical texts on the organ's functions and properties, parallel to the art movements in which the fascinating iconography of Prometheus is reviewed. The book offers a surprising interplay of art and medicine, placing emphasis on the unique morphology of the liver.

Mount Sinai Expert Guides: Hepatology will provide gastroenterology and hepatology trainees with an extremely clinical and accessible handbook covering the major liver diseases and symptoms, their diagnosis and clinical management. Perfect as a point-of-care resource on the hospital wards and also as a refresher for board exam preparation, the focus throughout is on providing rapid reference, essential information on each disease to allow for quick, easy browsing and assimilation of the must-know information. All chapters follow a consistent template including the following features: - An opening bottom-line/key points section - Classification, pathogenesis and prevention of disease - Evidence-based diagnosis, including relevant algorithms, laboratory and imaging tests, and potential pitfalls when diagnosing a patient - Disease management including commonly used medications with dosages, when to perform surgery, management algorithms and how to prevent complications - How to manage special populations, ie, in pregnancy, children and the elderly - The very latest evidence-based results, major society guidelines (AASLD/EASL) and key external sources to consult In addition, the book comes with a companion website housing extra features such as case studies with related questions for self-assessment, key patient advice and ICD codes. Each guide also has its own mobile app available for purchase, allowing you rapid access to the key features wherever you may be. If you're specialising in hepatology and require a concise, practical guide to the clinical management of liver disease, bought to you by one of world's leading hospitals, then this is the perfect book for you. This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from iTunes, Google Play or the MedHand Store.

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.

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.

From embryology to epidemiology, pathophysiology, diagnosis, complications, treatment and prognosis, this book provides a comprehensive overview and the latest evidence-based data on pancreaticobiliary maljunction (PBM), a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall. Resulting in various pathologic conditions, such as biliary cancer and pancreatitis, immediate prophylactic surgery is recommended upon diagnosis. The standard operative procedure for congenital biliary dilatation (CBD) is extrahepatic bile duct resection with bilioenteric anastomosis, but the optimal treatment of adult patients with PBM without biliary dilatation remains highly debatable. This book, written by pioneering editors and authors provides latest data, sheds new light on the disease. With abundant figures to aid understanding, Pancreaticobiliary Maljunction and Congenital Biliary Dilatation appeals to a wide readership, especially adult and pediatric surgeons, physicians including gastroenterologists and endoscopists, as well as radiologists and pathologists.

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.

Get the authoritative, up-to-date information you need on liver disease from the 7th Edition of the most trusted reference worldwide. Covering both basic science and recent clinical developments, this revised edition by Drs. Arun J. Sanyal, Thomas D. Boyer, Norah A. Terrault, and Keith D. Lindor, provides an in-depth, comprehensive look at the pathophysiology, diagnostic, and treatment information related to the liver. More than 1,100 figures and tables, many new and in full color, highlight completely updated content throughout. Expert, international authorship and comprehensive, easy-to-access information makes this edition the gold standard in the field of hepatology. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, videos, and references from the book on a variety of devices. Includes new information on the rapid changes in treatment paradigms for acute liver failure, the latest treatments for primary biliary cholangitis, full coverage of the gut microbiome and its role in liver disease, the newest developments in drug-induced liver injury, and changes in hepatitis C virus treatment and hot-button concerns about access to care. New summary boxes at the end of each chapter and a newly streamlined table of contents make it easier to find and understand the information you're looking for. Hundreds of brand-new illustrations clearly present key aspects of liver disease.

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.

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.

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.

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 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.

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.