In consultation with Dr. Charles Lightdale, Dr. DiMaio has assembled a list of articles devoted to endoscopy in hepatology with the most current and clinically relevant content. Dr. DiMaio invited top experts from well-known institutions to contribute reviews on the following topics: EUS in the evaluation of unexplained biliary dilation and liver function test abnormalities; EUS-guided liver biopsy; Advances in endoscopic imaging of the biliary tree; Expert evaluation of indeterminate biliary strictures; Stenting for benign and malignant biliary strictures; Endoscopic management of biliary issues in the liver transplant patient; Endoscopic management of complex biliary stone disease; EUS-guided biliary drainage; ERCP and EUS-guided drainage of the gallbladder; EUS-guided interventions for the measurement and treatment of portal hypertension; Endoscopic management of portal hypertension-related bleeding; EUS for diagnosis and staging of liver tumors; ERCP-guided ablation for cholangiocarcinoma; and EUS-guided ablation of liver tumors. Readers will come away with the most current clinical information they need to improve outcomes in patients with liver disease.

The Guest Editors have put together an issue of clinical reviews that provides the most current look at PBC. Authors, all experts in their respective areas, have submitted articles in the following areas: Changes in epidemiology of PBC; Genetic and epigenetics in PBC; Role of bile acids and the bicarbonate umbrella in the pathogenesis of PBC; Current treatment options in PBC; Work in progress: Drugs in development; Natural history of PBC in the UDCA era: Role of scoring systems; Treatment of Pruritus: Tricks of the trade; Chronic complications of cholestasis: Work-up and Management; Individualizing care: Management beyond medical therapy; Role of liver biopsy: When to do, how to stage; AMA-negative PBC: Is it really the same as AMA-positive PBC?; New thoughts on Overlap syndrome with auto-immune hepatitis; and Current status of liver transplantation for PBC.

With collaboration from Consulting Editor Dr. Norman Gitlin, Dr. Rosenthal has created an issue that provides current clinical information on the diagnosis and treatment of liver diseases in children. Expert authors from top institutions have contributed review articles on the following topics: Biliary atresia; Alagille Syndrome; Hepatitis B & C in Children; NAFLD/NASH; Bile acid defects; Progressive Familial Intrahepatic Cholestasis; Autoimmune hepatitis/PSC/Overlap syndrome; Portal hypertension/Cirrhosis in Children; Alpha-1-antitrypsin deficiency; Hepatic tumors; Acute Liver Failure; and Liver transplantation in Children. Readers will come away with the information they need to make clinical decisions that will improve patient outcomes.

The last forty years have witnessed the discovery of five human hepatitis viruses: hepatitis virus A, B, C, D, and E, and two related blood-borne viruses: GB virus C and TT virus. Viral Hepatitis provides a comprehensive overview of the latest developments and research studies in human viral hepatitis. Written by leading international scientists in the field, this book covers topics ranging from the history of these viruses to their molecular biology, diagnosis, epidemiology and control. It will be an invaluable reference source for hepatitis researchers, reference and diagnostic laboratories, clinicians, public health officers and graduate and medical students.

Dr. Pyrsopoulos has assembled the top authors in the field to provide current reviews on acute liver failure, to be the first time this topic is addressed in one volume. Topics are devoted to Classification and Epidemiologic Aspects of Acute Liver Failure; Acute Liver Failure: Mechanisms of disease and multi-systemic involvement; The Pathology of Acute Liver Failure; Liver Regeneration in the Acute Liver Failure Patient; Viral Hepatitis and Acute Liver Failure: Still a Problem; Drug- induced Liver Injury and Acute Liver Failure; Acetaminophen and Acute Liver Failure; Non-Viral Or Drug-Induced Etiologies of Acute Liver Failure; The Clinical Spectrum and Manifestations of Acute Liver Failure; Non ICU Management of Acute Liver Failure; Management of Acute Liver Failure in the ICU Setting; Prognostic Models of Acute Liver Failure; The Role of Liver Transplantation in Acute Liver Failure; and Future Approaches and Therapeutic Modalities for Acute Liver Failure. Readers will come away with a current point of view about how to approach and manage the patient with acute liver failure.

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.

Consultations of Gastroenterology practitioners are frequently sought for many complex issues relating to acute and chronic liver disease. Many of the disease entities are uncommon and complicated in scope. Liver disease may occur in the setting of other chronic medical conditions and involve other organ systems, with recommendations for diagnostic strategies and therapeutic approaches somewhat challenging. Serious consequences are often the rule with misdiagnosed or inadequately treated liver disease. Dr. Flamm has provided a framework for approaching consultation for common liver-related problems for the gastroenterology practitioner. Articles are devoted to the following topics: Common Findings and Interpretation for the Clinician; Genetic Testing in Liver Disease: What to Order and When; Acute Liver Failure; Liver Disease in Oncology Patients; Primary Sclerosing Cholangitis: What the Gastroenterologist/Hepatologist Needs to Know; An Update on the Treatment and Follow up of Patients with PBC; Wilson's Disease: Diagnosis, Treatment, and Follow Up; Follow Up of the Post-Liver Transplantation Patient: A Primer for the Practicing Gastroenterologist; Liver Disease in Patients on Total Parenteral Nutrition; Treatment Strategies in NAFLD: What's Coming; Resistance Testing in Chronic HCV; and HCV genotype 3: Treatment Approach and Natural History.

Obesity has devastating effects on a patient's overall health, with specific negative effects on organ systems, long-term. The hepatologist must often manage diseases of the liver and pancreas as a result of obesity. This issue will provide a current update on the diagnosis, treatment, and management of NAFLD and NASH. Dr. Bernstein has assembled the top leaders in the field to provide timely clinical reviews. Articles are devoted to the following topics: Clinical and economic burden of NAFLD/NASH; NAFLD/NASH in children and its implications; Natural history of NAFLD/NASH; Diagnosis and evaluation of NAFLD/NASH; Radiological imaging in NAFLD/NASH; The use of liver biopsy in NAFLD: When to biopsy and in whom; Pathophysiology of NAFLD/NASH; Risk factors for the development of NAFLD/NASH including genetics; Role of intestinal microbes in NAFLD/NASH; NAFLD/NASH and the metabolic syndrome; NAFLD/NASH and lipid and insulin resistance; NAFLD/NASH and cardiac disease; Current treatment of NAFLD/NASH; Emerging treatment of NAFLD/NASH; NAFLD/NASH and HCC and NAFLD/NASH and liver transplantation. Readers will have a clear understanding of how to manage outcomes for these patients.

This volume serves as a reference for the dissemination of advances made in the study of Hepatitis B Virus (HBV). Hepatitis B Virus: Methods and Protocols details protocols and techniques ranging from cell culture studies to in vivo and clinical immunology. The chapters in this book discuss treatments of in vitro infection systems, analysis and quantification of cccDNA and its mutations; in vitro polymerase activity assays; cellular trafficking of core proteins; intracellular calcium metabolism; detection, cloning, and sequencing of HBV markers; and new strategies aimed at exploiting new mechanisms for drug discovery. The book also covers classical methods for resolution of extracellular viral particles by native gel electrophoresis, and methods for detecting HBV antigens in drug discovery. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Cutting-edge and comprehensive, Hepatitis B Virus: Methods and Protocols is a valuable tool for researchers to use toward their advanced studies in HBV.

This volume provides a concise yet comprehensive overview on surgical procedures performed on the cirrhotic patient. The text explains the underlying pathophysiologic alterations in liver disease and cirrhosis, provides assessment of disease severity and risk factors, and helps to predict potential outcomes based on the nature of the operation. Operations discussed in detail include bariatric surgery, colorectal surgery, hepatic surgery, kidney transplantation, gynecological procedures, neurosurgical procedures, and ophthalmic surgery. The book is also supplemented with instructive color illustrations and tables. Written by experts in the field, Surgical Procedures on the Cirrhotic Patient is a valuable, multidisciplinary resource for clinicians who treat the cirrhotic patient. With a Foreword by Thomas E. Starzl, the father of liver transplantation.

This volume is composed of chapters that review important fundamental aspects of HCV biology and disease pathogenesis including, for example, the discovery and identification of the HCV genome, early virus-cell interactions including identification of various cellular receptors, HCV gene expression studied using the HCV replicon system, identification and characterization of HCV structural- and non-structural HCV proteins, HCV replication in cultured cells, and host factors involved in viral replication. This volume also contains chapters dealing with immunity to HCV infection and pathogenesis. This is particularly important in understanding hepatitis C because HCV infection alone is not cell lytic. Mechanisms underlying the persistent nature of HCV infection are also discussed in these chapters. Many of the authors published articles that were listed among the "top 10 papers" published in the 24 years since HCV was discovered in 1989. Their citations are above 1,000 (Web of Science). The authors describe the background and significance of their contributions to the field in the context of findings from other research groups.

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.

HBV is most prevalent viral infection worldwide. Recent advances in HBV virology epidemiology and management are of utmost importance particularly during this time when HCV is taking the front row in discussion and research. However, there's an increased interest in management of HBV in special populations, which is covered in this issue. The authors also explore drugs in the pipeline as well as new approaches for achieving long-term viral suppression and possibly cure.

This book will provide current understandings about two ubiquitously expressed metabotropic GPCRs, G-coupled purinoreceptor type 2 (P2Y) and Takeda G-protein-coupled bile acid receptor 5 (TGR5). G protein coupled receptors (GPCRs) are the largest family of proteins implicated in majority of cellular responses. The two receptor sub-families play a central role in many physiological functions as well as in many pathological conditions. This book offers up-to-date information on the physiological functions, signaling pathways and regulatory mechanisms of P2Y and TGR5 receptors. In addition, this book provides a comprehensive overview about the abnormalities of P2Y/TGR5 receptors and their contribution in the development and progression of pathological conditions. It also covers the currently available natural, chemical and pharmacological agents targeting these two receptor families and their therapeutic implications in P2Y and TGR5 associated disorders. This book is a valuable source for beginners and researchers to follow the rapidly progressing field of these two GPCR subfamily members.

This issue of Critical Care Clinics focuses on Hepatology and Critical Care. Articles include: Acute on Chronic and Decompensated Chronic Liver Failure, Hepatic Encephalopathy, Respiratory Complication in Liver Disease, GI Issues in Liver Disease, Bridging the Patient with Liver Disease to Transplant or Recovery, Infections in Liver Disease, Kidney Injury in Liver Disease, The Liver in Critical Illness, Hematological Issues in Liver Disease, Pharmacological Issues in Liver Disease and more!

Alcohol abuse remains a significant problem world-wide. The most commonly affected organ remains the liver with a risk of alcoholic liver disease (ALD) which can range from asymptomatic to alcoholic hepatitis to alcoholic cirrhosis. In 2010, alcohol-attributable cirrhosis was responsible for 0.9% of all global deaths. Given the sheer magnitude of alcohol abuse and alcoholic liver disease, an update on this topic is pertinent and relevant. This issue will focus on a variety of topics including alcoholism, the pathogenesis of ALD, the spectrum of ALD, the pathology of ALD, and the long-term management of patients with ALD. Alcoholic hepatitis is a particular type of ALD with a high mortality. This issue will explore the syndrome of alcoholic hepatitis, its prognostic markers, and the available therapies. Because alcohol intake can influence so many other conditions of the liver (especially hepatitis C), articles in this issue will also explore the impact of alcohol abuse on other liver conditions. In addition, several other topics such as nutritional therapy for ALD, ALD and liver cancer, and ALD and infection risk will be explored. Also, even though it is quite controversial, we will also explore liver transplant as a therapy for alcoholic liver disease including alcoholic hepatitis.

Due to the current obesity epidemic, non-alcoholic fatty liver disease (NAFLD) is prevalent in a significant portion of the United States patient population. It is being increasingly recognized that NAFLD affects both adults and children and can progress to end stage liver disease with resultant cirrhosis, portal hypertension, and hepatocellular carcinoma. In addition, several extrahepatic conditions may be linked to NAFLD including cardiovascular disease, insulin requiring and type 2 diabetes mellitus, obstructive sleep apnea, colonic adenomas, hyperuricemia, vitamin D deficiency, hyperferritinemia, pancreatic steatosis, hypothyroidism, and polycystic ovarian syndrome. Therapies for NAFLD are evolving rapidly. This issue will analyze patient demographics, risk factors, pathophysiology, patient presentation, and treatments for NAFLD.