Iron Physiology and Pathophysiology in Humans provides health professionals in many areas of research and practice with the most up-to-date and well-referenced volume on the importance of iron as a nutrient and its role in health and disease. This important new volume is the benchmark in the complex area of interrelationships between the essentiality of iron, its functions throughout the body, including its critical role in erythropoiesis, the biochemistry and clinical relevance of iron-containing enzymes and other molecules involved in iron absorption, transport and metabolism, he importance of optimal iron status on immune function, and links between iron and the liver, heart, brain and other organs. Moreover, the interactions between genetic and environmental factors and the numerous co-morbidities seen with both iron deficiency and iron overload in at risk populations are clearly delineated so that students as well as practitioners can better understand the complexities of these interactions. Key features of the volume include an in-depth index and recommendations and practice guidelines are included in relevant chapters. The volume contains more than 100 detailed tables and informative figures and up-to-date references that provide the reader with excellent sources of information about the critical role of iron nutrition, optimal iron status and the adverse clinical consequences of altered iron homeostasis. Iron Physiology and Pathophysiology in Humans is an excellent new text as well as the most authoritative resource in the field.

This book reports the recent progress in gene and cell therapy through the liver and aims to facilitate a comprehensive understanding of the current aspects and future prospects from basic research to clinical therapies. Edited by pioneering researchers, this volume presents extensive information to principal investigators, researchers, postdocs and clinicians for examining the wide varieties of pathological conditions both inside and outside the liver. Providing not only the basic and clinical aspects of therapy, this volume is special in that it focuses on the administrative and regulatory difficulties of actual clinical application and legal regulations in different parts of the globe. By indicating the advantages and limitations of the most promising gene and cell therapies targeting the liver, this book will inspire readers to develop a feasible treatment in the next generation.

Due to the latest developments in magnetic resonance imaging for the evaluation of liver pathology, a second, completely revised and enlarged edition of this book was felt necessary - despite only three years having elapsed since the first edition. All chapters from the first edition have been revised and enriched with additional illustrations and information. New chapters have been added covering important and highly relevant topics, among which imaging of pseudolesions, imaging of neoplastic diseases in pediatric subjects, imaging of bile ducts, MR angiography and imaging pre and post liver transplantation. Particular attention has been paid to the differential use of contrast agents with emphasis placed on the authors' broad experience of MR imaging of focal liver lesions using different contrast agents. The diverse mechanisms of action of all MR contrast agents applicable for liver imaging are explained in detail and comparative examples are provided. As was the case with the first edition, this book will prove invaluable to radiologists wishing to further expand or consolidate their routine approach to MR imaging of the liver.

This textbook provides a comprehensive and state-of-the-art overview of the major issues specific to the field of pediatric gastroenterology, hepatology, and nutrition. The first part of the book, Gastroenterology and Nutrition, presents in a systematic way the overall scope of issues encountered by children (newborn to teenagers) suffering from disorders of the gastrointestinal tract, pancreas and/or presenting nutritional issues. These chapters are structured in logical sections to facilitate consultation and include major topics ranging from congenital disorders to gastrointestinal problems of the newborn, infectious diseases of the gastrointestinal tract, and approach to nutritional problems in the various pediatric ages. The second part of the book, Hepatology, is articulated in a series of chapters which present a comprehensive review of congenital and acquired disorders of the biliary tract and liver. This section also includes a critical analysis of available diagnostic and therapeutic procedures and future perspectives. Written by experts in the field, Textbook of Pediatric Gastroenterology, Hepatology and Nutrition: A Comprehensive Guide to Practice constitutes a much needed, innovative resource combining updated, reliable and comprehensive information with agile consultation for a streamlined approach to the care of children with such disorders.

This volume provides a comprehensive, state-of-the art review of the management of pancreatic lesions. The book reviews the differential diagnosis and pathology of different pancreatic lesions, profiles new advances in endoscopic evaluation, highlights new perspectives about imaging modalities, describes current treatment strategies and provides an algorithmic approach to management of pancreatic tumors. Recently published literature is placed in context with current management recommendations. The text also discusses the latest advances in minimally invasive techniques, such as Endoscopic Retrograde Cholangio-Pancreatography (ERCP) and Endoscopic Ultrasound (EUS). Written by experts in their fields, Pancreatic Masses: Advances in Diagnosis and Therapy is a valuable resource for gastroenterologists, surgeons and internists that helps guide patient management and stimulate investigative efforts.

This book will be an excellent tool for practitioners seeking an update on the latest developments in the diagnosis and management of cirrhosis and portal hypertension. Among the topics addressed are risk stratification, prognosis, screening and surveillance, impact of etiological and antifibrotic therapy, the gut microbiome and cirrhosis, prevention of decompensation/further decompensation, management of the acute bleeding episode, controversies in pediatrics, and vascular diseases of the liver in cirrhotic and noncirrhotic portal hypertension. The book is a compilation of lectures and important consensus statements from the Sixth Baveno International Consensus Workshop on Portal Hypertension, the most recent of a series of workshops held every 5 years for hepatologists with an interest in the field. Portal Hypertension VI will serve as a reference book for clinical and research fellows in Gastroenterology and Hepatology and should inspire new research projects in the areas identified as promising by the experts of the Baveno VI Faculty.

The Oxford Handbook of Paediatric Gastroenterology, Hepatology, and Nutrition has been fully updated, with new chapters on transplantation, nutritional management, and liver function and biopsy to increase the breadth and depth of coverage of this range of closely related disciplines. Written by a team of experts at the top of their field, this handbook is a practical reference manual containing information on the day-to-day management of both rare and common conditions that are encountered by those who regularly see children with gastroenterology, hepatology, and nutritional problems. Containing up-to-date information and clearly organised for ease of reference, management guidelines and references to key articles for further reading are included to make this handbook an invaluable resource for both established and trainee clinicians, as well as other members of multidisciplinary teams such as specialist nurses, dieticians, and pharmacists.

This beautifully illustrated monograph provides an up-to-date and comprehensive overview about all fields of liver and biliary tract surgery and liver transplantation. It consists of four sections with 48 chapters: Section I: Anatomy, physiology, imaging and general principles, Section II: Biliary tract surgery, Section III: Liver surgery and Section IV: Liver transplantation. The book includes more than 500 figures and illustrations mostly in color. Some of the topics such as computer assisted surgery planning are treated comprehensively for the first time. The book is written in a concise and well conceived way.

A new era for liver anatomy has dawned. With the development of multidetector row computed tomography (MDCT) in the 1990s, precise volume-rendered 3-D images could be constructed, leading to new observations. Liver anatomy has since been reevaluated from the standpoint of portal segmentation and drainage veins and includes a reclassification of the liver. Better surgical results and fewer complications have supported the rationale for the new liver anatomy. Based on the work and spirit of Team Chiba from Chiba University, this publication is a testament to the collaboration, perseverance, and innovation in the field of liver anatomy. With high regard for the early pioneers in this field, Team Chiba can be credited with pioneering its own antiviral treatment, percutaneous ethanol injection therapy, radiation therapy, and US-guided hepatic resections. It is the team's hope that the new liver anatomy will find acceptance worldwide and will contribute to the advancement of the health and welfare of mankind.

This book, based on the experience of a single large referral center, presents the characteristic findings obtained when using MR imaging and MR cholangiopancreatography (MRCP) to image the biliary tree and pancreatic ducts in a variety of disease settings. An introductory chapter is devoted to technical considerations, anatomy, and developmental anomalies. Subsequent chapters then present in detail the MR imaging and MRCP findings observed in choledocholithiasis, inflammatory and neoplastic disorders of the bile ducts, acute and chronic pancreatitis (according to etiology), and different pancreatic neoplasms. Dynamic MRCP with secretin stimulation is also illustrated, documenting both normal and abnormal responses of the pancreatic duct system to secretin. Readers will find this book to be an excellent aid to the interpretation of MR imaging and MRCP findings in patients with biliary and pancreatic disease.

This text provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for students, clinicians, and researchers with an interest in hepatitis B. The book reviews new data about basic and translational science including the viral life cycle, the immunopathogenesis of virus induced chronic hepatitis, the mechanism of virus induced liver cancer, and their potential applications for the clinical management of patients. The clinical aspects of this chronic viral infection are reviewed in detail with important chapters on the global epidemiology, the natural history of the disease, co-infections with its satellite virus HDV or HIV, and management of special patient populations. A major emphasis is made on the management of antiviral therapy and the recent international guidelines for the treatment of hepatitis B. Finally, the book reviews the current state of the art regarding immunoprophylaxis to prevent the spread of the virus and its major clinical consequences. The new advances and perspectives in the development of improved antiviral treatments are also discussed. Hepatitis B Virus in Human Diseases will serve as a very useful resource for students, physicians and researchers dealing with, and interested in, this challenging chronic viral infection. It will provide a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts. All chapters are written by experts in their fields and include the most up to date scientific and clinical information.

Understanding Liver Cancer is a concise and up-to-date review, which discusses diagnosis, management, patient care, current and emerging therapies, and useful resources that clinicians can provide to their patients. Busy healthcare professionals who want a quick review of liver cancer as well as a summary of current therapies will benefit from this succinct text."

Surgery is the gold standard treatment of colorectal liver metastases. Patients management had a dramatic evolution during the past years: more accurate diagnostic tools and more effective chemotherapy regimens have been introduced and surgical indications have been widely broadened. A multidisciplinary treatment is now mandatory, involving oncologists, radiologists an gastroenterologists. However, many topics are still debated. In the present book all aspects of surgical treatment of colorectal liver metastases are analyzed based on a systematic, updated analysis of the literature. Aim of this book is to provide surgeons, oncologists and radiologists a clear overview of the state-of-the-art of treatment of colorectal liver metastases.

Liver disease is a widespread and increasing problem throughout the world, however little is published on how different types and degrees of liver dysfunction affect the body's ability to handle medicines."Drugs and the Liver" is designed to assist practitioners in making pragmatic choices for their patients. It aims to: enable the practitioner to assess liver function using biochemical markers, other tests, signs, symptoms and disease knowledge; identify which pharmacokinetic and pharmacodynamic parameters of a drug are likely to be affected by different types of liver disease; and consider the impact of a drug's side effects on a patient with liver disease.This practical guide covers background information on liver function, the principles of drug use in liver disease and includes a section of worked examples of commonly asked questions. It will be invaluable to clinical pharmacists and anyone making medicine choices in patients with liver impairment.

Portal hypertension is the abnormal pathophysiologic state that develops in liver cirrhosis and certain other disorders with characteristic clinical and hemodynamic features. There has been great progress in our under standing and management of portal hypertension, particularly in the diagnostic and therapeutic approaches. The so-called Banti's syndrome, a disorder whose existence had long been questioned, is now a well-defined portal hypertensive disease. The recently introduced Doppler ftowmetry is currently yielding new information on portal hemodynamics. Endoscopic sclerotherapy and beta-blockers have come to be widely used in the man agement and prevention of variceal bleeding. In spite of all these advances, a number of unsolved questions remain, such as whether sclerotherapy, pharmacotherapy or surgery is warranted for prevention of bleeding, which is more effective as an elective treatment, the surgical or endoscopic approach, and whether surgical portacaval shunt should be totally replaced by selective shunt operations. These new developments and problems are clearly and comprehensively described and discussed by the foremost authorities in 44 chapters, which are divided into five sections: 1) Patho physiology, 2) Hemodynamic Investigations, 3) Imaging Investigations, 4) Clinical and Pathological Features, and 5) Esophageal and Gastrointestinal Bleeding. The primary goal of this monograph, to provide a framework of patho physiology of portal hypertension with authoritative descriptions of the clinical and laboratory manifestations of various portal hypertensive dis orders, has clearly been achieved by these excellent contributions.

Since the discovery of superoxide dismutase more than three decades ago, there has been rapid growth in the knowledge of oxidative stress and disease. This volume containing the proceedings of the 13th Yamaguchi Symposium on Liver Disease includes discussion of the direct cellular effects of hepatitis C virus (HCV) proteins on hepatocytes and reviews evidence that oxidative stress caused primarily by the HCV core protein plays a key role in disease pathogenesis. Also included are chapters on new aspects of oxidative stress and liver disease such as carbon monoxide as a regulator of liver microcirculation, hepatic iron accumulation and the incidence of hepatocellular carcinoma, and oxidative stress in the absence of inflammation in hepatocarcinogenesis. This collection of papers from the Yamaguchi Symposium creates a valuable reference resource for physicians and hepatologists.

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.

As we approach the end of this millennium, enteric diseases remain impor tant public health problems. In many parts of the world, sanitary measures have advanced little over the last century, although some of the governments in those areas are striving to improve facilities for sanitation and to educate their people in proper handling of food, water, sewage, and other modes of transmission of pathogenic microbes. Even in highly developed countries, outbreaks of diarrheal diseases occur today. Globally, the annual morbidity from enteric infections is estimated at several billion and deaths at several million per year. In this volume, descriptions of some of these diseases, of immunity that results from them, of clinical studies that promote under standing of individual and community immunity, of molecular factors of pathogenesis, and/or of advances in vaccine development have been pro vided by leading researchers. At present, the application of molecular methods is enhancing the identification of protective antigens of many microorganisms. In addition, new methods for design and delivery of vac cines are being devised. Perhaps then more effective tools for reducing at least some of these diseases will be available within the next decade. Lois J. Paradise Herman Friedman Mauro Bendinelli vii Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv LOIS J. PARADISE 1. Indigenous Microorganisms as a Host Defense 1 KENNETH H. WILSON 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2. Composition of Intestinal Biota. . . . . . . . . . . . . . . . . . . . . . . . 2 3. Molecular Approaches to Determine Composition of the Biota . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4. Role of the Host in Determining the Composition of the Biota . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Movement disorder specialists, general neurologists, hepatologists, general gastroenterologists, and psychiatrists are the specialists who will most likely see some Wilson's disease patients during their careers. See them - yes. Recognize and diagnose them - maybe. If you are in one of these specialties, and a patient with tremor, hepatitis, cirrhosis, apparent Parkinsonism, or mood disorder, is referred to you, will you appropriately recognize the possibility that the underlying diagnosis may be Wilson's disease? Wilson's disease is both treatable and reversible, and commonly misdiagnosed. This book aims to change this with comprehensive coverage of every aspect of Wilson's disease, from well-catalogued, easy-to-use clinical diagnostic tools to treatment methods to molecular biology. Dr. Brewer is the world's leading expert on Wilson's disease, seeing and caring for over 300 patients with the disease during the last 20 years. He is a professor of human genetics at the University of Michigan.

The condition of prolonged obstructive jaundice with patent bile ducts was first described in 1851 by Addison and Gull of Guy's Hospital, London. The term primary biliary cirrhosis (PBC) was defined in 1950 by Ahrens and colleagues of the Rockefeller Institute, New York. The condition was considered rare but this changed in 1965 with the discovery of a definitive diagnostic serum mitochondrial antibody test and the recognition that a raised serum alkaline phosphatase value, often discovered incidentally, could be a diagnostic pointer. If the diagnosis is made earlier, the end stages are rarely reached as death is replaced by liver transplantation. On November 6th 1997, in Chicago, an International Faculty discussed in depth the clinical features, pathogenesis and treatment of PBC, no longer considered a rare disease. The course of PBC is long, but some 18 years after the discovery of a positive mitochondrial antibody test in a symptom free patient with normal serum biochemistry, 83% will have developed abnormal tests and 76% will be symptomatic. Identification of those who will progress rapidly is difficult. The serum antimitochondrial profile may be useful but this is a very specialist technique. Mathematical prognostic models are useful in therapeutic trials and in the selection and timing of patients for liver transplantation but have limited value in individual patients. An increasing serum bilirubin level remains the most important indicator of rapid progression. Its value however can be negated by the use of ursodeoxycholic acid which has a bilirubin-lowering effect."

This book intends to provide a comprehensive and up-to-date description of the newest techniques in minimally invasive liver surgery. The treatment of liver diseases comprises a significant component of the practice of any general surgeon working either in the academic, general and community hospitals. With the rapid expansion of knowledge and technology also the liver has been approached laparoscopically in a few specialized centers with well recognized advantages for the patients. Now this large amount of experience will be made universally available through this book. After a concise description of the main tools and technology necessary to carry out a safe laparoscopic and/or robot-assisted liver surgery, details of operative techniques will be illustrated. Each chapter will consist of an introduction, a summary of the indications and contraindications of specific operative procedures and a detailed description of each surgical procedure, including the potential complications of both the surgery and the postoperative care. A special effort will be done to provide informative and accurate illustrations and pictures, that will be completed by the DVD containing the movies illustrating the technical procedures performed by the leading European liver surgeons.

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

A series of international symposia on viral hepatitis and liver disease has been held triannially, and called the "Olympics" of this research field. Our book presents the results of the eighth of these "Olympiads" which for the first time, was held in Asia (May 1993, Tokyo). Due to the rapid progress in research on both basic and clinical aspects of viral hepatitis and liver disease, the state of the art in this field is continually being updated, and our book provides a broad and in-depth survey of current work. The major topics in our book include molecular biology of the five known hepatitis viruses (HAV, HBV, HCV, HDV, and HEV), clinical implications of genetic variants of HBV and HCV, interferon treatment of HCV-related liver disease, and worldwide epidemiology and control of viral hepatitis. New subjects not seen in previous books, such as genotypes of HCV, are also covered. Expanding knowledge about the heterogeneity of the HCV genome has revealed a great variety of genotypes as well as their association with host pathogenesis and their varying responsiveness to interferon therapy. The first promising results of efforts to develop a hepatitis C vaccine are also presented. Finally, compared with its predecessors, our book contains many more papers from Asian countries, where the prevalence of viral hepatitis and liver disease is the highest in the world.