Chronic liver disease is one of the most prevalent diseases in the developed world. The large amount of new knowledge has resulted in subspecialities, even in issues such as hepatology. Thus every day, it is more difficult to access all relevant information that is being published. Additionally, biomolecular techniques lead to a level of complexity that is only beneficial when dealt with by professionals. This book attempts to give a broad overview of the molecular biology of the liver, emphasizing how this knowledge is the basis of further treatment. Thus, pathophysiology and therapies are updated in viral hepatitis, hepatic encephalopathy and portal hypertension, among others. However, appended issues that apparently are less relevant such as the stem cell and endocannabinoids are included. These two issues will soon be of importance due to their close relationship with the liver tissue and especially with liver disease. There are also new paradigms such as cell death and the implication of the extracellular matrix, which are also addressed. In addition, important issues such as the stellate cells and their intimate relationship with fibrogenesis are treated in-depth. Also the fundamental role of endothelin in chronic liver disease is examined. Because of its prevalence, NASH was discussed with special interest, with a focus on the process from fatty liver to molecular biology of liver cells and metabolism in chronic liver disease. The authors believe that this is a broad vision that describes the basic pathophysiological mechanisms shared by many liver diseases, giving rational support for specific therapies.

Gallstone disease is one of the most prevalent digestive diseases, resulting in a considerable amount of financial and social burden in the USA. Approximately 20 million Americans have gallstones. Because gallstone disease is a common clinical problem, basic and clinical studies on this disease continue to advance at a rapid pace, and a book focusing on basic science, current diagnosis and management of gallstones will greatly help practicing gastroenterologists, gastroenterological endoscopists, physicians and surgeons to understand the etiology of this disease and the availability of effective medical therapies. In this book, recognised medical experts discuss recent advances in the epidemiology, pathophysiology, pathogenesis, genetics and diagnosis, as well as endoscopic, medical and surgical therapies of gallstone disease. This compilation on gallstone disease was written by fifty authors from eight countries (Canada, China, Germany, Italy, Japan, the Netherlands, the United Kingdom, and the USA). There are thirty chapters in this book. Chapters One and Two discuss the epidemiology and natural history of cholesterol and pigment gallstone disease. Chapters Three through Six summarise recent progress in the pathogenesis of gallstone disease from a physical-chemical and pathophysiological perspective. Chapter Seven elucidates the roles of the immune system and the microbiome on the pathogenesis of cholesterol gallstones. Chapters Eight and Nine review the roles of nuclear receptors and the enterohepatic circulation of bile acids in cholesterol gallstone diseases. Chapters Ten through Twelve discuss the discovery of Lith genes and more fundamental knowledge concerning the genetic determinants and the molecular mechanisms underlying the critical role of Lith genes in gallstone formation in mice and humans. Chapter Thirteen discusses gallstones in pregnancy and explains why gallstone prevalence is higher in women than in men. Chapters Fourteen through Eighteen discuss the effects of diet, insulin resistance, obesity, diabetes, and nonalcoholic fatty liver disease on the formation of cholesterol gallstones. Chapter Nineteen provides diagnostic flow charts for biliary lithiasis. In Chapter Twenty, important non-invasive imaging findings of common gallbladder pathology are reviewed, and current strategies for the optimal use of imaging in the evaluation of patients with suspected gallbladder disease is discussed. Chapter Twenty-One evaluates current pharmacological therapy in cholesterol gallstones. Chapter Twenty-Two describes laparoscopic cholecystectomy. Chapters Twenty-Three through Twenty-Six discuss surgical treatment and endoscopic management of common bile duct stones and hepatolithiasis. Chapter Twenty-Seven reviews recent progress on the endoscopic treatment of bile duct stones with endoscopic papillary large balloon dilation. Chapter Twenty-Eight addresses surgical treatment of gallstones and their complications. Chapter Twenty-Nine discusses treatment of intrahepatic duct stones from a Western perspective. Chapter Thirty describes the history and incidence rate of Mirizzi syndrome, and summarises recent progress in its classification, diagnosis, and management. The articles in this book provide a state-of-the-art review of the current knowledge on the lithogenesis and the management of gallstone disease, as well as promote future epidemiological investigation, basic and translational research, and clinical studies on this prevalent biliary disorder worldwide.

Acute cholecystitis is a pathological entity of inflammatory origin, with a high prevalence worldwide. The term cholecystitis defines an inflammation of the gallbladder. Although most people with gallstones do not have symptoms and will not go on to develop cholecystitis, cholecystitis occurs most commonly due to blockage of the cystic duct with gallstones (cholelithiasis). In this book, Chapter One provides a contemporary review of acute cholecystitis (AC). Chapter Two examines the diagnosis and treatment options for AC. Chapter Three focuses on the diagnostic work-up of patients with AC. Chapter Four discusses early and delayed cholecystectomy as a treatment for AC. Chapter Five examines the current literature as it pertains to the management of patients who present with Grade II (moderate) acute cholecystitis, specifically looking at the timing of operation and the appropriateness of drainage procedures. Chapter Six reviews cholecystitis in systemic lupus erythematosus.

Dx/Rx: Liver Cancer is a quick and practical reference guide containing all aspects of the diagnosis and therapy of hepatocellular carcinoma (HCC), prognostic and staging systems, clinical management, molecular biology, current controversies, and future insights. Organized into a condensed, bulleted format, this concise reference offers precise and up-to-date information on the epidemiology, classification, diagnosis, treatment, and risk factors for cancers of the liver. Presented in a handy, easy-to-read format, Dx/Rx: Liver Cancer is a must-have resource for oncologists, internists, primary care physicians, and other health care professionals on the ward or in the clinic.

Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product. An intense, streamlined review for the gastroenterology board exam Gatroenterology and Hepatology Board Review: Pearls of Wisdom, 3e is a unique question and single-answer review for gastroenterology in-service and board exams. The book features about 3,500 questions with only the correct answer provided, reinforcing the answer students need to remember on exam day. Emphasis is placed on distilling key facts and clinical pearls essential for exam success. Features NEW chapter organization by anatomy to help poinpoint areas of weakness FULL COLOR image gallery NEW chapters on Radiography and Endoscopy

Whether You're A Newly Diagnosed Patient, Survivor, Or Loved One Of Someone Suffering From Liver Cancer, 100 Questions & Answers About Liver Cancer, Third Edition Offers Essential And Practical Guidance. Providing Both Doctor And Patient Perspectives, This Completely Updated And Revised Edition Offers Authoritative Answers To The Most Commonly Asked Questions About Liver Cancer Including Diagnosis, Treatment, Post-Treatment Quality Of Life, And Coping Strategies. Written By A Medical Oncologist And A Gastrointestinal Surgeon, With Actual Patient Commentary, 100 Questions & Answers About Liver Cancer, Third Edition Is An Invaluable Resource For Anyone Coping With The Physical And Emotional Turmoil Of This Disease.

With approximately 8,000 liver transplant operations per year world-wide, this surgical procedure has become relatively routine. Improvements in surgical and anesthetic techniques and immunosuppression have resulted in improved outcomes, but cardiovascular events and sepsis remain the principal obstacles to further lowering morbidity and mortality rates. Consequently, cardiovascular assessment and optimisation are of increased interest to anaesthetists and other professionals involved in liver transplant programs. This book summarises the current knowledge on preoperative hemodynamic profiling and cardiovascular assessment of patients awaiting liver transplantation.

This book presents topical research in the study of liver cirrhosis, including etiologic types of end stage chronic liver disease; hepatocellular carcinoma screening in the cirrhotic patient; hepatic myofibroblasts and their role in liver fibrogenesis; the role of trace elements in the pathogenesis of liver cirrhosis and cell-based therapy for liver cirrhosis.

Designed as an easy-to-use and comprehensive reference for the practicing pathologist, "Diagnostic Pathology: Hepatobiliary and Pancreas" is the next highly anticipated title in "The Diagnostic Pathology series" offered by Amirsys. As readers have come to expect from this series, "Diagnostic Pathology: Hepatobiliary and Pancreas is filled with superior medical images, including gross photographs, photomicrographs, and detailed medical illustrations. As with our other Diagnostic Pathology titles, chapters include definitions, terminology, etiologies and pathogenesis, demographics, clinical presentations, therapy, prognoses, radiologic imaging, pathology, and differential diagnoses. The pathologic features are extensively detailed with descriptions of the macroscopic features, microscopic findings, cytopathology (as indicated), and as needed, ancillary studies. The latter include histochemistry, immunohistochemistry, cytogenetics, molecular diagnostics and ultrastructural findings. There are also a variety of quick-reference test data tables, as well as helpful introductory chapters, annotated and illustrated staging templates, and chapters on specimen examination handling. This handsome volume is a veritable one-stop shop for your hepatic, biliary, and pancreatic pathology reference needs.

Insulin resistance (IR) and metabolic syndrome are associated with the pathogenesis and progression of non-alcoholic fatty liver disease (NAFLD). It encompasses a spectrum of hepatic pathology, ranging from simple steatosis in its most benign form (fatty liver), going through nonalcoholic steatohepatitis (NASH) in its intermediate form, until cirrhosis and hepatocellular carcinoma, its most advanced forms. This book presents current research on the background of fatty acid oxidation; hepatic steatosis and its progression to NASH and cirrhosis; fibrosis and myofibroblastic cells differentiation; methods of diagnosis; clinical features and laboratory tests and, finally, rodent NAFLD and NASH models.

This book provides a single reference for all transplant professionals involved in the care of HCV patients who have unique problems not encountered in other liver transplant patients. In the liver transplant community, it is well-known that decompensated cirrhosis from hepatitis C virus (HCV) is the leading indication for orthotopic liver transplantation (OLT) in the United States and most Western countries. Short-term results which initially seemed promising and comparable to other carefully selected liver transplant recipients now appear less encouraging with cirrhosis developing in 10-25% of patients by 5 years. Despite these concerns, there is an increased amount of data which supports re-transplantation in carefully selected patients.

The Hepatic circulation is unique among vascular beds. The most obvious unique features include the dual vascular supply; the mechanism of intrinsic regulation of the hepatic artery (the hepatic arterial buffer response); the fact that portal blood flow, supplying two thirds of liver blood flow, is not controlled directly by the liver; the fact that 20% of the cardiac output rushes through the most vascularized organ in the body, driven by a pressure gradient of only a few millimeters of mercury; the extremely distensible capacitance and venous resistance sites; the unidirectional acinar blood flow that regulates parenchymal cell metabolic specialization; and the high concentration of macrophagic (Kupffer) cells filtering the blood. The liver is the only organ reported to have regional blood flow monitored by the autonomic nervous system. This mechanism, when dysfunctional, accounts for the hepatorenal syndrome and offers a mechanistic therapeutic target to treat this syndrome. The trigger for liver regeneration is dependent on hepatic hemodynamics so that chronic liver blood flow regulates liver cell mass. In severe liver disease, the whole body circulation is reorganized, by forming portacaval shunts, to accommodate the increased intrahepatic venous resistance. These shunts protect the venous drainage of the splanchnic organs but lead to loss of major regulatory roles of the liver. The development of knowledge of the hepatic vasculature is presented from a historical perspective with modern concepts summarized based on the perspective of the author's four decades of devotion to this most marvelous of organs. Table of Contents: Acknowledgements / Historical Perspectives / Overview / Fluid Exchange / Capacitance / Resistance in the Hepatic Artery / Resistance in the Venous System / Fetal and Neonatal Hepatic Circulation / In Vivo Pharmacodynamic Approaches / Nitric Oxide / Adenosine / Hepatic Nerves / Hepatic Circulation and Toxicology / Hepatorenal Syndrome / Integrative Hepatic Response to Hemorrhage / Blood Flow Regulation of Hepatocyte Proliferation / Multiple Mechanisms Maintaining a Constant Hepatic Blood Flow to Liver Mass Ratio / Pathopharmacology and Repurposing Drugs as a Research Strategy / References

Sex does matter. One of the most compelling reasons for understanding the biological differences, which are not so explained at this time, is that there are striking differences in human disease. The most obvious and best-studied differences between the sexes are in the reproductive systems. Much less study has been done on sex differences in non-reproductive areas of biology. Liver cancer is undoubtedly predominant in men and postmenopausal women. Almost anyone may "feel," but not recognise the sex-associated difference in liver cancer as a fact. How does sex matter in the incidence of liver cancer? After considering the data and examples presented in this book, anyone will be provided unique opportunities to obtain a better understanding of differences of chronic liver disease between the sexes. Some of these differences can be explained by what we now know. Some are unexplained and point to important questions for future study. Being female or male is an important basic human variable that affects health and liver disease throughout the life span. A better understanding the biological mechanisms underlying the sex-associated differences in chronic liver disease would provide valuable information to design care of health and liver disease more effectively for individuals, both females and males.

Hepatic insulin resistance and altered insulin metabolism, as characterised by the desensitisation of hepatic parenchymal cells to insulin, play a role in the pathogenesis of liver disease, particularly resulting in steatosis and steatohepatitis. By the same token, type II diabetic patients are at higher risk for developing liver diseases, including steatosis, hepatitis, cirrhosis, and hepatocellular carcinoma. On the other hand, established liver disease from any cause leads to glucose intolerance and peripheral insulin resistance systemically. The link between insulin resistance and liver pathology reviewed in this book suggests that insulin resistance is closely related with a variety of liver diseases. Recent evidence indicates that the AMP activating protein kinase (AMPK) in conjunction with p70 ribosomal S6 kinase 1 (S6K1) serves as a key signalling pathway regulating insulin-dependent physiological functions; thus, this pathway serves as a target for the therapy of diseases associated with insulin resistance. In this chapter, the regulatory role of the AMPK-S6K1 pathway is discussed in terms of enhancing insulin receptor signalling with insulin receptor substrate-1/2 and phosphatidylinositol phosphate kinase activity, which may contribute to preventing and/or treating insulin resistance in the liver.

Liver disease is a rapidly growing speciality, and nurses and health care professionals need to have the relevant knowledge and skills to care for patients with liver problems in a safe and effective way. "Liver Diseases" is a comprehensive, evidence-based, practical guide to the nursing care and management of patients with liver disease.

"Liver Diseases" explores a range of liver conditions, including cirrhosis, portal hypertension, alcoholic liver disease, viral hepatitis, autoimmune hepatitis, Wilson's disease and acute liver failure. It looks at the anatomy & physiology of the liver, assessment of liver function and diagnostic studies, acute and chronic liver disease, pregnancy related liver disease, liver transplantation and infectious liver diseases. For each condition the epidemiology, complications and nursing management are provided, along with illustrative case studies and further reading. "Liver Diseases" is an invaluable tool for all nurses and health care professionals working with people with liver disease.
SPECIAL FEATURESThe first UK book on care of the liver from a nursing and healthcare perspectiveWritten by a well-respected and renowned author in the fieldCovers a wide spectrum of liver diseases, with relevant nursing management guidelinesWith case studies, further reading and illustrations throughout

This book discusses in detail new aspects of the metabolic basis of important chronic liver diseases. Entities such as non-alcoholic fatty liver disease (fatty liver and Non-Alcoholic SteatoHepatitis -- NASH), diabeties in chronic hepetitis C, hemochromatosis, Wilson's disease, Gaucher disease, porphyria, as well as liver cirrhosis and its metabolic consequences will be discussed in detail. These clinical conditions are highly prevalent and affect millions of patients in the USA and world-wide. For example, non-alcoholic fatty liver disease is the most common cause of elevated liver enzymes in the general population. This field has been practically transformed over the last few years, with many new insights gained, regarding both pathogenesis and effective novel treatments.