Liver cancer, cirrhosis and nonalcoholic fatty liver disease are observed predominately in men. Being male or female is believed to be an important human variable that affects health and liver disease throughout the life span. However, few works have been published on the biological mechanisms underlying gender specific differences in liver disease. Several mechanisms underlying sex-associated differences of progression of liver disease are demonstrated in this e-book based on biological factors as estrogen and hepatic iron stores. Readers will gain a better understanding of the pathogenesis of these sex-associated differences in liver disease and on how to design healthcare for liver disease more effectively for individuals belonging to both genders. The e-book should be a useful reference on gender specific medicine for counselors and clinicians as well as for patients with chronic liver disease.

During the last two decades microsurgery has progressively taken the place of macrosurgery since it largely improves the experimental models in liver research. This is a concise but comprehensive book focusing on key issues in microsurgical techniques for liver research. The book has been written for medical, biological, veterinary and pharmaceutical researchers and advanced students who wish to develop experimental models of liver diseases by using microsurgery. The book is organized in twelve chapters in which the basic and applied aspects of experimental liver surgery are included. Many illustrations are given to reproduce each microtechnique which should particularly useful to the readers.

The eBook discusses how the special physiology of the liver must be considered when applying functional molecular imaging in hepatology. The main topics of the eBook include the clinical and scientific use and possibilities of functional molecular imaging for investigations of hepatic blood perfusion, substrate metabolism, and biliary secretion as well as for cancer diagnostics (primary and secondary liver cancers). Functional imaging of changes in cerebral blood perfusion and metabolism in patients with liver diseases is also covered. The eBook is written by internationally renowned experts and is intended for everyone who is interested in hepatology or functional molecular imaging.

Some time ago, Schiano raised the question "To B or not to B", which means "To Biopsy or not to Biopsy" the liver for the evaluation of chronic hepatopathies. For a long period, liver biopsy (LB) was considered the "gold standard" for the evaluation of liver morphology. A major disadvantage of LB is its invasiveness: the risk of post-biopsy discomfort for patients and sometimes, for serious complications; also the lack of sensitivity to detect fibrosis, due to its heterogeneity; and the inability to obtain good quality fragments, adequate for pathological examination. In these conditions, the question is whether LB can be regarded as the "gold standard" for staging and grading chronic hepatitis in daily activity. But what alternative can we propose for the evaluation of liver fibrosis at this moment? The answer is: non-invasive methods and the ultrasound elastographic ones presented in this volume. Transient Elastography (FibroScan, Echosens) is a recognized method in many countries. Published papers and meta-analyses showed the value of this method for the diagnosis of liver cirrhosis (AUROC - 94%); for staging chronic HCV hepatitis (a cut-off value of 7.5 kPa differentiates F0–1 from F2–4 with 67% sensitivity, 87% specificity, 86% positive predictive value (PPV) and 68% negative predictive value (NPV), with a diagnostic accuracy of 76%; but also in HBV chronic infection, NASH, PBC, PBS). Acoustic Radiation Force Impulse (ARFI) Elastography (Siemens S2000) is another elastographic methods with promising results (a meta-analysis showed that the mean diagnostic accuracy of ARFI expressed as AUROC was 0.88 for the diagnosis of significant fibrosis (F≥2), 0.91 for the diagnosis of severe fibrosis (F≥3), and 0.93 for the diagnosis of liver cirrhosis. In the subgroup of patients who underwent both ARFI and TE, the diagnostic accuracy of ARFI was comparable to TE for the diagnosis of significant and severe fibrosis, with a trend to be inferior for the diagnosis of cirrhosis. The future of liver fibrosis evaluation points towards non-invasive methods, decreasing dramatically the number of liver biopsies. Studies have been published regarding the value of Real Time Elastography, performed for the first time with Hitachi systems (EUB-8500 and EUB-900), which uses an extended combined autocorrelation method to produce a real-time elasticity image by using a freehand approach to compress the tissues with the ultrasound transducer. The relative tissues’ elasticity is calculated and displayed as a color overlay on the conventional B-mode image. HiRT-E could be a promising method for the evaluation of liver fibrosis in chronic hepatopathies, but new methods of color code interpretation are needed to improve the accuracy, as well as a reference acquisition methodology. ShearWave™ Elastography, the new "kid on the block", produces an image where true local tissue elasticity is displayed in a color map in "real time". Elasticity is displayed using a color coded image superimposed on a B-mode image. Stiffer tissues are coded in red and softer tissues in blue, with an image resolution of approximately 1mm. The true elasticity is assessed based on Shear wave propagation speed into the tissue. It is a very new method and only small studies were presented at international meetings. Thus, having the alternative of noninvasive elastographic methods for the evaluation of liver fibrosis (maybe together with serum tests such as FibroMax) and knowing the low real life yield of liver biopsy (and the risk of complications), we can safely conclude that, for daily medical activity, liver biopsy can be avoided in the vast majority of cases. This ebook presents an interesting set of chapters on the subject and is of good value to hepatologists interested in non invasive diagnostic methods for liver diseases.

This e-book covers Helicobacter pylori research as it looks in 2014. The discovery of the bacterium in 1982 by B.J. Marshall and R. I. Warren had a tremendous impact on basic research and clinical medicine, resulting, in the past 3 decades, in more than 34,000 published articles. The editor of this volume and the contributing authors have compiled a unique collection of chapters dealing the with the microbiology, epidemiology, clinical diagnosis and treatment of H. pylori infections in a country-specific manner, with contributors having the opportunity to present the peculiarities and specifics of Helicobacter research in their area or country without overlapping any other previously published e-book. This e-book is a useful reference for gastrointestinal physicians and medical researchers seeking the latest information related to H. pylori.

Acute and chronic liver disease is a global endemic healthcare concern. More than 500 million people around the world are infected with the hepatitis B or C virus. Approximately 500,000 patients die of hepatocellular carcinoma every year, implying that trained healthcare professionals and facilities for liver disease patients is a critical issue. Although promising therapies have been developed for viral hepatitis infections, management of liver cirrhosis, and hepatocellular carcinoma yet many patients suffer due to lack of adequate healthcare by professional hepatologists. This means that primary care physicians should be informed about diagnosing liver disease and the early management of viral hepatitis and hepatocellular carcinoma. Comprehensive Practical Hepatology provides readers current standard primary care guidelines for treatment and early stage management of patients with liver function abnormalities. This book provides a practical approach for physicians to apply on patients with apparent liver function abnormalities. The guidelines also cover: Acute and chronic liver injury, Information about the liver in systemic diseases, Drug usage in liver diseases, Surgical risk in liver disease patients, and, Recommendations for pregnant as well as elderly patients. Comprehensive Practical Hepatology thus provides complete practical advice on the management of liver diseases to non-hepatologists and general physicians.

The gastrointestinal tract is a series of organs each with distinct mechanical functions. Each organ within the system brings food contents in the gut lumen to the site of absorption through separate mechanical functions. These mechanical functions are generated by a fine-tuned interaction between neuronal networks and active muscle layers. The passive components of the gastrointestinal wall such as the collagen-rich submucosa also play an important role in these mechanical actions. Clinical Mechanics in The Gut provides a thorough understanding of the anatomy and biomechanics of the physiological function and pathophysiology of the gastrointestinal tract. The book first gives an introduction to readers about the physical geometry of the gastrointestinal tract followed by a detailed explanation of biomechanical theory and its application to approximating and modeling gut mechanics. This is expanded further by detailed explanations of gut muscle and motor nerve functions in proceeding chapters. A biomechanical evaluation of disorders of regulatory mechanisms such as achalasia and Hirschsprung disease and disorders of effector mechanisms such as reflux disease, systemic sclerosis of the gastrointestinal tract and colonic diverticular disease are also included. Readers will, therefore, gain an understanding about clinical problems in gastroenterology from a bioengineering and modeling perspective. Clinical Mechanics in The Gut is a useful reference for gastroenterology researchers, biomedical engineers and systems biologists seeking to understand the physiology of the gut and applying this knowledge to surgical procedures, computer-based modeling systems and robotics.

Principles of Hepatic Surgery introduces the reader to current trends in Liver surgery knowledge and practice. This reference book covers liver surgery fundamentals as well as cutting-edge progress in this exciting surgical specialty. Contributions have been written by expert hepatic surgeons from major medical centers around the world. Key features include:  Information organized into five comprehensive sections: i) Liver Anatomy and Perioperative Care, ii) Approach to Malignant Hepatic Disease, iii) Approach to Benign Hepatic Disease, iv) Technical Aspects of Liver Resections, and v) Liver Transplantation  Over 350 illustrations  Truly effective didactic text, with logical, clear explanations, giving readers a pleasant reading experience  Commentary sections written by experts for specific surgical cases. Principles of Hepatic Surgery is a valuable reference for both novice hepatologists and practicing liver surgeons.

Liver biopsy (LB) is sometimes considered to be the "gold standard" for the evaluation of liver morphology in the diagnosis of chronic hepatopathies. A major disadvantage of LB is its invasiveness: the risk of post-biopsy discomfort for patients and sometimes, of serious complications; the lack of sensitivity to detect fibrosis, due to its heterogeneity and the difficulty to obtain adequate physical samples for pathological examination is also problematic. In these circumstances, the idea of LB as the "gold standard" for staging and grading chronic hepatitis in routine medical diagnoses is questionable. Non-invasive methods such as ultrasound elastography provide an effective alternative for liver evaluation without the risk of complications that arise from liver biopsies. There are a number of variants of elastographic techniques which include transient elastography (FibroScan, Echosens), Acoustic Radiation Force Impulse (ARFI) elastography (Siemens S2000) and other methods of shear wave elastography. This revised edition of Hepatic Elastography Using Ultrasound Waves presents an updated set of chapters on the related topic. Chapters cover several methods of hepatic elastography (transient, shear wave, real time strain, elastPQ etc.). This edition consolidates all methods of point shear wave elastography (including ARFI and ElastPQ methods) into a single chapter and presents information on 2D shear wave elastography in a separate chapter. In addition, this revised edition offers readers new information on the comparison of each elastographic technique and supplements readers with a set of general guidelines on liver elastography. This revised edition is an essential reference for hepatologists interested in non invasive diagnostic methods for liver diseases.

Non-alcoholic fatty liver disease (NAFLD) is a common cause of elevated liver enzymes and chronic liver disease in Western countries. NAFLD is characterized by elevated liver enzymes in the absence of alcohol consumption and secondary causes of liver disease. It is an independent predictor of future risk of cardiovascular diseases, type 2 diabetes and metabolic syndrome (hypertension, abdominal obesity, dyslipidemia, glucose intolerance). This book is a quick reference guide for medical students and professionals about NAFLD. Readers will find a summary of epidemiology, clinical features, diagnosis, imaging techniques, histopathology, and disease management. The book also presents information about NAFLD linked with hepatocellular carcinoma and guidelines for treating NAFLD in pediatric patients. Each chapter presents information in a simple, structured manner making this text an ideal handbook for supplementing hepatology modules in medical curricula.