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Recent advances in technology have greatly impacted upon the practice of nuclear medicine in general, and the approach to hepatobiliary diseases in particular. Empha sis is now placed more on non-invasive functional imaging with quantification, a feature unique to nuclear medicine and not available from any other competing diag nostic imaging modality. By providing a measure of severity of disease, quantification aids not only in timing of therapy but also for testing whether or not the chosen therapy has achieved the intended goals and objectives. This is the first textbook of its kind in the new millennium on nuclear hepatology to fully integrate quantitative physiology with morphology in the diagnosis of hepatobiliary diseases. The conception of nuclear hepatology occurred in the late 1940s with the introduc tion of radiocolloids, whose rate of clearance from blood was used as a measure of hepatic blood flow. Radiocolloid imaging of the liver, introduced first in the mid 1950s, was the most popular nuclear medicine imaging procedure in the 1970s and early 1980s, accounting for nearly 50% of the total workload in many nuclear medicine departments.
Since the publication of the first edition of Nuclear Hepatology almost 10 years ago, new advances have taken place, both in our understanding of liver pathophysiology and various imaging modalities. A unique feature of imaging of physiology is that it enables quanti- cation. Since liver physiology is complex, quantification has been a challenge. Many p- lications in the past have often included quantification based on home-made software not available for others. Thus, the comparison of results from one center to another becomes difficult, if not impossible. The second edition of Nuclear Hepatology addresses these issues. Sophisticated software for liver and gallbladder function has been tested and va- dated through many of our previous publications. Now that software is FDA approved and available for others through a commercial company, it is hoped that future publications of imaging of liver and gallbladder physiology would routinely include quantification. Although the function of the hepatocyte is complex, it can be broadly divided into two main categories, substrate uptake at the basolateral border and intracellular transit prior to excretion into the canaliculi. The earliest manifestation of hepatocellular injury occurs in the form of prolongation of the intracellular transit time, which occurs long before the disruption of the basolateral border with subsequent rupture and death. The liver enzymes are released into circulation after the death of the hepatocyte.
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.
THE encyclopedic guide to hepatology – for consultation by clinicians and basic scientists Previously the Oxford Textbook of Clinical Hepatology, this two-volume textbook is now with Blackwell Publishing. It covers basic, clinical and translational science (converting basic science discoveries into the practical applications to benefit people). Edited by ten leading experts in the liver and biliary tract and their diseases, along with outstanding contributions from over 200 international clinicians, this text has global references, evidence and extensive subject matter – giving you the best science and clinical practice discussed by the best authors. It includes unique sections on: Symptoms and signs in liver disease Industrial diseases affecting the liver The effects of diseases of other systems on the liver The effects of liver diseases on other systems It's bigger and more extensive than other books and discusses new areas in more depth such as stem cells, genetics, genomics, proteomics, transplantation, mathematics and much more. Plus, it comes with a fully searchable CD ROM of the entire content. Click here to view a sample chapter on the liver and coagulation
Clinical Hepatology – Principles and Practice of Hepatobiliary Diseases provides clear and comprehensive coverage of the etiology, mechanisms of disease, diagnosis, and practical management of the entire spectrum of liver and biliary disorders. It also affords an excellent, evidence-based review of the rapidly expanding field of hepatobiliary diseases.
This book is the first to provide balanced examination of both pediatric liver disease and liver transplantation – two topics that are inherently related, given that most chronic liver disorders eventually require organ replacement. The different forms of liver disease encountered in the pediatric age group are first discussed in a series of disease-specific chapters that have a reader-friendly, uniform structure covering pathophysiology, diagnostic and treatment algorithms, clinical cases, and transition to adult care. Key topics in the field of liver transplantation are then addressed. Examples include indications and contraindications, surgical techniques and complications, immunosuppression, in pediatric liver transplantation, acute and chronic rejection and allograft dysfunction, and CMV and EBV infection in transplant recipients, long-term graft injury and tolerance. A section on pediatric hepatology across the world includes chapters presenting the features and management of pediatric liver disease in South-America, Africa and Asia. A closing section considers what the future holds for pediatric liver disease and its management, including novel genetic testing, cell therapy and gene therapy. Pediatric Hepatology and Liver Transplantation will be of value for a range of practitioners, from residents making their first approach to pediatric liver disease through to specialists working in transplantation centers.
Bridging the gap between basic scientific advances and the understanding of liver disease — the extensively revised new edition of the premier text in the field. The latest edition of The Liver: Biology and Pathobiology remains a definitive volume in the field of hepatology, relating advances in biomedical sciences and engineering to understanding of liver structure, function, and disease pathology and treatment. Contributions from leading researchers examine the cell biology of the liver, the pathobiology of liver disease, the liver’s growth, regeneration, metabolic functions, and more. Now in its sixth edition, this classic text has been exhaustively revised to reflect new discoveries in biology and their influence on diagnosing, managing, and preventing liver disease. Seventy new chapters — including substantial original sections on liver cancer and groundbreaking advances that will have significant impact on hepatology — provide comprehensive, fully up-to-date coverage of both the current state and future direction of hepatology. Topics include liver RNA structure and function, gene editing, single-cell and single-molecule genomic analyses, the molecular biology of hepatitis, drug interactions and engineered drug design, and liver disease mechanisms and therapies. Edited by globally-recognized experts in the field, this authoritative volume: Relates molecular physiology to understanding disease pathology and treatment Links the science and pathology of the liver to practical clinical applications Features 16 new “Horizons” chapters that explore new and emerging science and technology Includes plentiful full-color illustrations and figures The Liver: Biology and Pathobiology, Sixth Edition is an indispensable resource for practicing and trainee hepatologists, gastroenterologists, hepatobiliary and liver transplant surgeons, and researchers and scientists in areas including hepatology, cell and molecular biology, virology, and drug metabolism.
This book is the proceedings of the Falk Symposium No. 135 held in Prague, Czech Republic, on September 12-13, 2003, and is dedicated to the important issue of immunological aspects of diseases of the liver and gut. Without any doubt, immunological pathways are among the most important and universal factors in the pathogenesis of all diseases. Their importance is also constantly increasing, because these principles have been adopted in clinical practice for both diagnostic and therapeutic procedures. Chapters by prominent experts will stimulate new ideas and set the scene for productive discussion on this topic.
Get the authoritative, up-to-date information you need on liver disease from the 7th Edition of the most trusted reference worldwide. Covering both basic science and recent clinical developments, this revised edition by Drs. Arun J. Sanyal, Thomas D. Boyer, Norah A. Terrault, and Keith D. Lindor, provides an in-depth, comprehensive look at the pathophysiology, diagnostic, and treatment information related to the liver. More than 1,100 figures and tables, many new and in full color, highlight completely updated content throughout. - Expert, international authorship and comprehensive, easy-to-access information makes this edition the gold standard in the field of hepatology. - Includes new information on the rapid changes in treatment paradigms for acute liver failure, the latest treatments for primary biliary cholangitis, full coverage of the gut microbiome and its role in liver disease, the newest developments in drug-induced liver injury, and changes in hepatitis C virus treatment and hot-button concerns about access to care. - New summary boxes at the end of each chapter and a newly streamlined table of contents make it easier to find and understand the information you're looking for. - Hundreds of brand-new illustrations clearly present key aspects of liver disease.