Liver disease has been identified as a leading cause of death in HIV-infected patients since the introduction of highly active antiretroviral therapy (HAART) in 1996. The HIV treatment community has been caught largely unaware of this emerging dilemma. Many HIV care providers are ill-equipped to understand and interpret liver injury patterns, or to provide comprehensive care and management for viral coinfections which they are not familiar with. HIV and Liver Disease provides a comprehensive update of the field covering the epidemiology, pathogenesis, management and treatment of liver disease in patients with HIV infection. The volume will help HIV care providers understand and interpret liver injury patterns, and/or provide comprehensive care and management for viral coinfections. Gastroenterologists and hepatologists will gain an understanding of complex drug regimens that are used to treat HIV and which may impact HCV and HBV treatment. Written by expert clinicians and researchers across multiple disciplines, HIV and Liver Disease will be of great value to gastroenterologists, hepatologists, infectious disease practitioners, as well as other health care providers who provide care or participate in research in the field of HIV.

It is now widely accepted that multidisciplinary collaboration and multimodality treatment approaches are important in improving the survival of patients with hepatocellular carcinoma. In this comprehensive textbook, internationally renowned experts in the field present and discuss the various strategies employed in the treatment of the disease. Up-to-date information is provided on the indications for and outcome of a range of treatment options, including surgical resection, liver transplantation, radiofrequency ablation, transarterial chemoembolization, yttrium-90 transarterial radioembolization, and systemic therapy. In addition, important background information is included on biology, pathology, staging, and imaging. This book will be particularly helpful to all professionals and trainees worldwide who have an interest in the diagnosis and treatment of hepatocellular carcinoma.

Dietary fibre is now recognized as a vital component of good daily nutrition, yet its properties and specific role in the digestive system are still being investigated. The involvement of government agencies, the food industry and health professionals - as well as public interest - make this global overview, Dietary Fibre - A Component of Food, an important contribution to the literature on the subject. The cooperation of experts from different research centers and their peer review of each other's papers enhance the value of the book, since it presents consolidated views and objective assessments on such key issues as fibre analysis and mineral bioavailability. The seventeen chapters are grouped into three sections. The background papers deal with biochemical and analytical characteristics: e.g. the physico-chemical properties of food polysaccharides and bacterial fermentation in the colon. The papers on physiological effects deal with the physiological function of dietary fibre throughout the gastrointestinal tract: its influence on protein, lipid and carbohydrate digestion and absorption and its role in bile acid metabolism and faecal bulking. The third section of papers focuses on the prevention and treatment of disease: gastrointestinal disorders, obesity, diabetes mellitus, and hyperlipidemias.

Liver Regeneration: Basic Mechanisms, Relevant Models and Clinical Applications presents cutting-edge information on liver regeneration research through an integrated, systems-wide perspective. The book addresses discoveries on hepatic progenitor cells, liver regeneration after chemical damage, and liver regeneration as a prime therapy for liver failure and disease. By addressing the urgent need for translating basic research findings into clinically relevant modalities and potential therapeutic applications, the book provides the data needed to improve liver patient management. Hundreds of full-color, graphic photographs and illustrations underline key elements and show researchers and students important aspects of liver transplantation, immunofluorescence, and other techniques used in liver regeneration.

This book - the first multicenter book on orthotopic liver transplantatio- reflects the progress in this field. The first 'experience in hepatic transplantation' was documented in 1969 by Starzl and his group in Denver in the classic of the same name. It was followed in 1983 by 'Liver transplantation', edited by Caine, in which the experience of the Cambridge-King's College Hospital team was laid down. Apart from these the book of Lie and Giitgemann appeared in 1974. These books are fundamental for all who want to become involved with experimental and clinical liver transplantation. Developments in liver transplantation are fast (faster than the production of this book) and new knowledge now not only is coming from the pioneer centers but also from their off-spring, scattered over the world. In only a few years there has been an enormous increase in the number of liver transplantations and certainly there have been performed at least as many transplants since 1980 as between 1963 -the start of clinical liver transplantation- and 1980. Even if our understanding is better, many problems are the same as twenty years ago and for some there may be a long way to go before they are solved.

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

By 1977 it was clear that the thermophilic campylobacters were a major cause of acute bacterial enteritis. In response to that observation an international workshop was convened in Reading, England, and attracted over 130 participants. Many of these individuals resolutely returned for the eighth in the series of biennial international workshops, this time held in Win chester, England, in July 1995. All were surprised at the continued, and even expanding, re search effort in this narrow microbiological field. Such a lasting interest is undoubtedly a reflection of a consistent rise in the incidence of infection, the growing number of closely re lated organisms and disease associations, and an ever-increasing awareness by the public and government agencies of public health and food safety issues. The second workshop in Brussels in 1983 was a forum that demonstrated the growing awareness in the campylobacter community of the existence of campylobacter-like organisms and provided the platform for presentations describing the association of these organisms, now classified in the genus Helicobacter. with gastroduodenal disease. The clinical aspects of the research into helicobacters is now thoroughly covered in several other meetings, and the remit of the international workshop has been expanded to provide a forum for the presentation of the basic microbiological research carried out on these bacteria. In a continuation of this ap proach the remit of the workshop has been further extended to other related organisms, reflect ing that there are many other campylobacter-like organisms still to identify and characterize."

Hepatology and Transplant Hepatology: A Case Based Approach presents a collection of interesting cases in liver disease seen at a very busy and large liver transplant center in the United States. These cases cover the full range of pathology that an internist or gastroenterologist may expect to see in a lifetime of taking care of patients with acute or chronic liver disease, before or after liver transplant. Each case is presented as you would see it in a clinical situation where a patient presents a complaint or something is noted on exam or blood work. The question/answer format will help one through the problem of making a diagnosis or in considering a differential diagnosis and also point to the best way to manage each condition. The volume is divided into pre-transplant and post-transplant hepatology. Each case is 3 pages with the first page presenting the case and pertinent lab data and 3-4 questions (i.e. differential diagnosis, tests to order, x-rays/CT required).The second page illustrates the tests, scans, biopsies and asks for the pertinent findings. The third page provides the diagnosis and what may have been expected with other diagnoses. Here is a single source dealing with questions specific for patients with complications of advanced liver disease and also clinical situations seen in transplant hepatology. Hepatology and Transplant Hepatology: A Case Based Approach will have great appeal to anyone in hepatology/transplant hepatology and also to residents/fellows and internists interested in gastroenterology.

In the past 15 years much evidence has accumulated which indicates the paramount importance of sensory nerves in reg ulating functions of the gastrointestinal tract. In parallel, the attention of researchers in this field has been increas ingly attracted to the role played by neuropeptides in the normal and diseased gut. Basic research on the peculiar properties of capsaicin, the pungent ingredient from plants of the genus Capsicum, has allowed the gap between these two areas of research to be bridged. Sincethen, the study of gut afferents and neuropeptides has become more and more interconnected and recognized as a major avenue to understand ing the pathophysiology of various human diseases. It is widely recognized that a certain subset of primary afferents synthesize, store and release neuropeptides (such as tachykin nins and calcitonin gene-related peptide) from their central and peripheral endings, the latter being widely distributed in the alimentary canal and related organs (liver, pancreas). The First International Meeting on Sensory Nerves and Neuropeptides in Gastroenterology, held in Florence from December 4-5, 1989, sponsored and organized by Fondazione Internazionale Menarini, aimed to focus the current status of research in this field. The contributions presented at the meeting and in this book delineate a suggestive scenario in which sensory nerves of the gut, and the multiple messages they carry through the release of neuropeptides, are to be considered as a major target for the development of new drugs potentially useful in a number of diseases of the gastro intestinal tract."

General Section. Progress in laparoscopy (new instruments, technical innovations, integration between laparoscopy and sonography). Special Section. Traditional and present indications for laparoscopy. Laparoscopy inliver diseases. Oncological lapaoscopy (diagnosis, staging and follow-up for malignant tumors). Emergency laparoscopy.

There is a tradition behind the current radiologic examination of the small bowel. Many of the great names in gastrointestinal radiology have established their reputations on the basis of their work in the small bowel. This is an area which is assuming ever greater importance for radiologists as its mucosal surface continues to elude the endos copist. Moreover, it is an aspect of radiology which calls for the greatest technical and interpretative skill. It is a great pleasure to welcome the English language version of this beautiful work on Radiology of the Small Intestine. English speaking physicians are frequently not as familiar with the large body of work published in French as they should be. Tant pis ! Dr. Bret and his co-workers have been pioneers in the pursuit of excellence in gastrointestinal radiology. During all the years that I have been involved in this field, I have admired their work.

The meeting that provided the material for this book was the 58th Symposium of the Federation of European Microbiological Societies (FEMS) entitled MOLECULAR PATHOGENESIS OF GASTROINTESTINAL INFECTIONS which was held in Helsingor, Denmark from 2nd to 4th September, 1990. The aim of this meeting was to bring together scientists from a range of discipline- microbiology, cell biology, molecular biology and immunology - to consider how microbes, including parasites, colonize and infect the gastrointestinal tract. The programme was designed to focus particular attention on the range of strategies whereby enterovirulent bacteria and parasites colonize the gastrointestinal mucin layer, how they adhere to and penetrate the epithelial layer by entering the cells or passing between them, and how various protein toxins may facilitate these processes. Speakers were especially encouraged to highlight the recent expansion in our knowledge of the molecular mechanisms by which enterotoxigenic and enteropathogenic Escherichia coli, shigellae, salmonellae and Yersinia enterocolitica cause intestinal disease. There were also discussions of recently-discovered gastrointestinal pathogens such as Clostridium difficile and Helicobacter pylori as well as accounts of how virulent determinants can be used to develop new diagnostic methods based on DNA gene probes and the polymerase chain reaction (PCR). These presentations provided the basis for the chapters in this book.

It is increasingly recognized that various transporter proteins are expressed throughout the body and determine absorption, tissue distribution, biliary and renal elimination of endogenous compounds and drugs and drug effects. This book will give an overview on the transporter families which are most important for drug therapy. Most chapters will focus on one transporter family highlighting tissue expression, substrates, inhibitors, knock-out mouse models and clinical studies.

Chronic liver failure is a frequent condition in clinical practice that encompasses all manifestations of patients with end-stage liver diseases. Chronic liver failure is a multiorgan syndrome that affects the liver, kidneys, brain, heart, lungs, adrenal glands, and vascular, coagulation, and immune systems. Chronic Liver Failure: Mechanisms and Management covers for the first time all aspects of chronic liver failure in a single book, from pathogenesis to current management. Each chapter is written by a worldwide known expert in their area and all provide the latest state-of-the-art knowledge. This volume is specifically designed to provide answers to clinical questions to all doctors dealing with patients with liver diseases, not only clinical gastroenterologists and hepatologists, but also to internists, nephrologists, intensive care physicians, and transplant surgeons.

Primary liver cancer is the third most deadly and fifth most common cancer worldwide (~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% 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.

Since 1998, the Japanese Society of Hepatology has campaigned to fight hepatocellu lar carcinoma (HCC). Because the mortality rate for this disease has reached more than 30 per 100,000 population, the organizing committee chose HCC as the main topic of the 1999 Yamaguchi Symposium on Liver Diseases. Regarding hepatocar cinogenesis, we know that HCC often develops secondary to liver cirrhosis; thus liver cirrhosis must be recognized as a prevalent pathological condition leading to HCC. If we can control liver fibrosis, we can reduce the risk for HCC among patients with chronic hepatitis. To achieve this goal, we must know more about hepatic fibrosis. Professor Michael J. P. Arthur is familiar as a leading scientist in this field. We were fortunate that he accepted our invitation to speak. His lecture titled "Mechanisms of the Progression and Regression of Liver Fibrosis" provided important advice for developing antifibrotic agents. We also invited Professor Mark A. Zern, who has been studying hepatic fibrosis for some time. In the symposium he talked about novel approaches, including gene therapy, to treat acute and chronic hepatic diseases in the 21st century. In addition to the informative talks by those guests from abroad, the lecture by Dr. J. Fujimoto was very impressive. He revealed that gene therapy using hepatocyte growth factor (HGF) could inhibit progression to liver cirrhosis in rats repeatedly injected with dimethylnitrosamine (DMN). Dr. Fujimoto has already pub lished his finding that administration of HGF reduced hepatocarcinogenesis in rats."

Primary liver cancer is a rather unusual malignancy in that the incidence varies tremendously from one geographical area to another. While relatively uncom mon in Western countries, it is the most prevalent malignant neoplasm in Southeast Asia, South Africa, and many other regions; in all, the countries in which primary liver cancer is very prevalent account for more than two-thirds of the world's population. In China alone, approximately 100 000 people die every year from primary liver cancer, mostly hepatocellular carcinoma. The incidence is rising in some countries, especially Japan, where it has doubled among males in the past 15 years or so, a staggering and puzzling trend. Since the demonstration of an etiological relationship between hepatitis B virus infection and hepatocellular carcinoma, intensive research has been con ducted in an effort to elucidate the role of the virus in hepatocarcinogenesis. Though much progress has been made, a full understanding of the molecular events leading to malignant transformation of the hepatocyte will probably require many more years of rigorous investigation. Chemical carcinogens and several industrial pollutants may also be involved in the etiopathogenesis of neoplastic liver disease."

The percentage of the population which is elderly has been increasing steadily in many countries in the world; and as this tendency continues, the question of how to treat the elderly rises in importance. The problem of how to manage hypertension in the elderly has become one of the most important issues in the prevention and treatment of cardiovascular disease. However, not many of the cIinical studies performed so far to evaluate the effects of antihypertensive drug treatment have incIuded the elderly. Many important problems remain unsolved. How much bene- ficial effect can be expected from active antihypertensive drug treatment in the elderly? How can isolated systolic hypertension, which is fre- quently encountered in the elderly, have better prognosis when treated? When is drug treatment indicated, to what level should blood pressure be reduced and maintained in the e1derly, and how should drugs be selected? The elderly also frequently bear other medical problems, either re- cognized or unrecognized, such as mental depression, respiratory problems, infection, malignant neoplasms, and water and electrolyte im- balances. The body's ability to eliminate drugs also decreases with age and necessitates modified dosage. The 12th Scientific Meeting of the International Society of Hyperten- sion held in Kyoto, Japan on May 22-26, 1988 incIuded the satelIite symposium. "How Should Elderly Hypertensive Patients Be Treated?" wh ich focused on the pathophysiology and outcome of elderly hyperten- sive patients.

Acute and chronic viral hepatitis infections are serious public health threats around the world. The different infections have different epidemiology and natural his- ries, and children play important roles in each of these. For example, children are important reservoirs for acute hepatitis A, childhood infections are responsible for most of the global morbidity associated with chronic hepatitis B, and perinatal transmission of hepatitis C continues to occur, even as the overall incidence of new infections wanes. Some non-A through E viral hepatitis infections are seen p- dominantly in infants and young children, while others have specific implications for this population. Therapeutic options for children with chronic viral hepatitis are limited when compared to those available for adults, especially for hepatitis B, and considerations given to long-term therapy have dramatic implications when dealing with the long life expectancy of these young patients. With these issues in mind, this unique volume has been created to address the special considerations regarding viral hepatitis in children. It includes the latest information and recommendations specifically directed at the pediatric population, and highlights the knowledge gaps which will need to be filled to improve our understanding of these infections and treatment of this special group. Experienced practitioners from around the world have contributed these reviews, incorporating the latest studies, the current recommendations, and the distinctive pediatric issues that shape clinical care, and will determine the research agenda for this field going forward.

The contents of this book represent papers which were presented at the Third International Meeting on "Side-Effects of Anti-Inflammatory and Analgesic Drugs" which was held under the auspices of the University of Verona, Institute of Pharmacology in Verona on 8-11 May 1991. This meeting was held in conjunction with the 13th European Workshop on Inflammation and although publications from this part of the meeting are not published here (they appear in Agents and Actions), we were fortunate in having a group of people interested in inflammation from varying backgrounds. The success of the third meeting followed previous meetings held in Cambridge and Verona respectively and continue a tradition which has now become well established. The meeting brought together physicians, scientists and those concerned with the production and use of anti-inflammatory drugs to a very stimulating conference to discuss basic issues affecting all aspects of side-effects of anti-inflammatory and analgesic drugs as well as their detection and treatment. The meeting was held in the Auditorium of Glaxo Italy and we are very grateful to that company for use of their facilities as well as to the University of Verona, Institute of Pharmacology, for valuable secretarial and administrative help. The success of the conference would not have been possible without valuable financial assistance of the companies listed separately (under Acknowledgements) as well as to the organizers of the 13th European Workshop on Inflammation who collaborated with us.

Portal hypertension is the most important complication of a great variety of both acute and chronic liver diseases. Nevertheless, hepatic cirrhosis is the most frequent cause of portal hypertension. Gastrointestinal bleeding due to rupture of oesophageal varices is, without doubt, the most severe complication of portal hypertension. At present, great advances are being made in the pathophysiology and in the development of new therapeutic tools for controlling and preventing this severe clinical event.

This book contains the papers presented and discussed during the Symposium on 'Portal Hypertension in the 21st Century', held in Montreal, Canada, in April 2004, and sponsored by Axcan Pharma Inc. and NicOx S.A. There are eight sections covering basic mechanisms, new drugs, prevention and current treatment of variceal bleeding, prevention of recurrent bleeding and hepatic hemodynamic monitoring.

An international faculty of authors have contributed chapters at an outstanding scientific level which will be vital reading for scientists and clinicians alike."

Recent advances in gastroenterology and hepatology as well as new findings in biliary and pancreatic diseases are presented in the proceedings of the 86th annual congress of the Japanese Society of Gastroenterology. From the hundreds of papers delivered at the congress, 70 were selected for inclusion here. Opening with special lectures on gastroenterology in the new millennium, ulcerative colitis-pathophysiology and therapy, and life style-related diseases and gastroenterology, the volume is divided into sections reflecting the major concerns of researchers in the science of digestive diseases in Japan today: apoptosis in digestive organs, nitric oxide, transcription factors in digestive organs, antigen-presenting cells, pathology of inflammatory bowel disease, NSAID-induced gastric lesions, microcirculation in digestive diseases, hepatic regeneration, and hepatic fibrosis.

The aim of this Atlas is to present the three-dimensional arrangement of the liver structures, which should be familiar to those who diagnose and treat diseases of the liver, particularly in an era when the methods of diagnostic imaging and surgical treatment are becoming increasingly sophisticated. For this purpose a series of corrosive preparations of the blood vessels and bile ducts of the liver was made and photographed. In addition to the normal situations, many frequent and rare variations are shown. The Atlas also shows some blood vessels that have not been adequately described or are not well-known in the reference literature, but are nevertheless of great importance in performing segmental liver resections.This Atlas takes a fresh approach to the subject. The method used allows the size, three-dimensional arrangement and structure of the blood vessels and bile ducts of the liver to be preserved. The majority of photographs were taken from the direction from which surgeons see the liver during an operation. This, together with the schematic presentations complementing most of the photographs, gives a further instructional value to the work. With colour photographs and explanatory text, the Atlas forms a basic guide to orientation inside the liver parenchyma, to understanding and diagnosing certain pathological processes and to planning surgcial procedures.

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.

Presenting patient- and problem-oriented review articles, this series is designed to keep the internist, general surgeon, and specialist in gastroenterology and hepatology abreast of the latest advances in the field.