This is a multi-author book on hilar cholangiocarcinoma, written by an international team of world-renowned experts covering topics in their respective areas of expertise. There are altogether 71 authors from 14 countries/regions, mainly Argentina, Australia, China, Germany, Italy, Japan, Korea, Malaysia, Thailand, the Netherlands, the United Kingdom and the United States of America. This book aims to provide an up-to-date, fully referenced text that is as succinct as possible, but as comprehensive as necessary, addressing all topics in hilar cholangiocarcinoma. It provides the latest findings in the rapidly advancing field of hilar cholangiocarcinoma. Controversial aspects are discussed by highly regarded authorities who look at the problem from different perspectives. A helpful list of references is included at the end of each chapter. The extensive use of diagrams, figures and tables makes the text easy to read. This book is primarily intended for clinicians and researchers who are interested in hilar cholangiocarcinoma, including liver surgeons, hepatologists, interventional and diagnostic radiologists, and basic researchers. General physicians, general surgeons, trainees, epidemiologists, hospital administrators, pathologists and instrument manufacturers will also find this book to be a valuable reference work. Editor Lau is currently a Professor of Surgery at the Chinese University of Hong Kong, and an Academician of Chinese Academy of Sciences, China.

Primary Liver Cancer: Surveillance, Diagnosis and Treatment focuses on the many therapies rapidly evolving to assist with controlling hepatocellular carcinoma as well as emerging technologies to assist in early diagnosis as well as prevention. All chapters are written by experts in their fields and include the most up to date information for diagnosis, treatment, surveillance, epidemiology, staging, recurrence and prevention. This volume will serve as a useful resource for clinical gastroenterologists, hepatologists, oncologists, pathologists, and physicians who treat patients with chronic liver disease and hepatocellular carcinoma.

Because of the increasing burden of hepatitis C and fatty liver disease, there is an explosion in the prevalence of chronic liver failure and hence its complications. The onset of Hepatic Encephalopathy (HE) in these patients has a significant impact on the quality of life, morbidity and mortality. Unfortunately, the approach observed by most clinicians to this complex disorder is minimalistic. This book provides a comprehensive review on pathophysiology and clinically important aspects in HE. Topics in basic physiology, nitrogen metabolism, new insights into pathogenesis and brain edema are covered in great detail. The authors have made a special effort by simplifying the complex aspects of pathogenesis and diagnosis so that it can be easily understood and applied clinically. This volume also focuses on recent developments regarding diagnoses of subtle forms of HE, also known as minimal or covert HE as well as on new treatments. Hepatic Encephalopathy will be of great value to gastroenterologists, hepatologists, pathologists, medical residents, fellows, internists and general practitioners who treat patients with hepatic encephalopathy.

This is a carefully illustrated volume of surgical procedures. Well-known standard as well as alternative procedures in surgery of the stomach and the proximal duodenum are depicted with anatomical exactness. Possible complications, errors, and dangers and how to avoid them are discussed in detail. Each operative step is illustrated superbly and accompanied by a short, precise text. Both illustrations and text stem from the practical experience in the operating theater of the many renowned surgeons who have contributed to this volume. The book serves as an indispensable reference for surgeons; likewise, gastroenterologists, radiologists, pathologists, and anatomists will find this volume of immeasurable value in their daily work.

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."

With a focus on practical patient related issues, Autoimmune Hepatitis: A Guide for Practicing Clinicians serves as a useful practical, and much needed, resource for all those physicians presented with managing patients diagnosed with autoimmune hepatitis, both acutely and over the long term. It provides a basis for clinicians to understand the etiology of the disease, as well as special circumstances where management dilemmas often arise. Emphasis is given to providing management advice of immediate use to clinicians, something not presently offered by other larger general texts. The chapters are written by those with an expertise and training in this field and include the most up to date information. The book will be of great value to Gastroenterologists, Hepatologists, and Internists at all levels who see patients presenting with autoimmune hepatitis.

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.

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.

Hyponatremia is a common electrolyte disorder found in a variety of settings. Manifestations range from subtle abnormalities to convulsions and death. New treatment options, such as Antidiuretic Hormone (ADH) antagonists, have created the need for a resource presenting the latest evidence and clinical approaches. Hyponatremia: Evaluation and Treatment is a comprehensive review of hyponatremia, with an emphasis on managing this disorder from diagnosis to treatment. The incidence and occurrence of acute and chronic hyponatremia in general terms are covered, as well as disorders of the central nervous system, heart and liver with their relation to hyponatremia. Common clinical scenarios are presented along with both traditional and new methods of treatment. Authored by experts on this disorder from around the world, experienced members of the medical community and trainees alike will find Hyponatremia as an indispensible guide to diagnosis, managing and treating patients with hyponatremia.

- Unlike previous atlases that deal with overall surgical techniques, this book goes into greater detail and focuses on individual cases.

- Lavishally illustrated with 534 illustrations, 133 of which are in color.

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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.

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.

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."

HepatitisE (HEV) is a viral infectious disease that infects humans and domestic, wild, and synanthropic animals alike. In developing countries, the disease often presents as an epidemic, transmitted primarily through the fecal-oral route. In recent years, sporadic cases have also been documented in industrial countries, including Europe. The identification and characterization of animal strains of HEV from pigs, wild boar, and deer, and the demonstrated ability of cross-species infection by these animal strains raise potential public health concerns for foodborne and zoonotic transmission of the virus. This Brief will provide a thorough overview of HEV. It will discuss the epidemiology and pathogenesis of the virus in both humans and animals, review detection methods, and provide methods for its control and prevention."

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."

Acute liver failure (ALF), or fulminant hepatic failure, is a distinct clinical syndrome which crosses medical disciplines. A relatively rare condition, ALF remains a major focus of clinical and research attention and with the advent of transplantation, the importance of understanding management of ALF has taken on a new urgency. In this 1997 volume, the editors bring together a distinguished team of contributors to describe the aetiology, pathology and treatment of this important syndrome. Also covered are consensus techniques in liver transplantation for ALF patients, as well as descriptions of artificial and bioartificial liver assist devices. A section on future treatments includes hepatocyte transplantation, auxiliary grafts and other temporary liver support. Notable for the high level of authors' expertise, this comprehensive volume should prove invaluable to internists, gastroenterologists, surgeons, and intensive care providers.

Hepatitis C virus (HCV), a major causative agent of chronic liver disease, is spread throughout the world and around 170 million people are persistently infected. In this volume, world-leading experts in the field of HCV research have compiled the most recent scientific advances to provide a comprehensive and very timely overview of the various facets of HCV. The book starts with a discussion of the possible origin of HCV and its spread among the human population. The focus of the subsequent chapters is on available cell culture and in vivo models before shifting to the molecular and cellular principles underlying the viral replication cycle. These chapters are complemented by insightful descriptions of the innate and adaptive immune responses to HCV as well as the virus-associated pathogenesis. Finally, the development of antiviral therapies, which is closely linked with progress in basic research, and the implementation of those therapies into present and future daily clinical practice are highlighted.

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.

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."

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.

Liver-Directed Therapy for Primary and Metastatic Liver Tumors is a comprehensive examination of tumors of the liver. It provides a unique multi-modality approach to management of all types of primary and secondary liver tumors. The biology of liver cancers, state of the art radiologic imaging and novel, non-surgical interventional strategies are given. There is an in depth analysis of surgical options including transplantation, resection, interstitial ablation techniques and liver-directed chemotherapy for hepatocellular carcinoma, bile duct cancers, and colorectal and neuroendocrine liver metastases. Because of the unique and comprehensive examination of liver tumors, this work is an excellent resource for surgical, transplant and medical oncologists, surgeons, gastroenterologists, and radiologists.