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Author : J. Reichen,Raoul E. Poupon
Publisher : Springer
Page : 242 pages
File Size : 55,7 Mb
Release : 1996-06-30
Category : Medical
ISBN : UOM:39015038136852
Therefore, surrogate markers for the different conditions are sorely needed in order to assess the value of these novel treatment modalities.
Author : Institute of Medicine,Food and Nutrition Board,Board on Health Sciences Policy,Board on Health Care Services,Committee on Qualification of Biomarkers and Surrogate Endpoints in Chronic Disease
Publisher : National Academies Press
Page : 335 pages
File Size : 51,8 Mb
Release : 2010-06-25
Category : Medical
ISBN : 9780309157278
Many people naturally assume that the claims made for foods and nutritional supplements have the same degree of scientific grounding as those for medication, but that is not always the case. The IOM recommends that the FDA adopt a consistent scientific framework for biomarker evaluation in order to achieve a rigorous and transparent process.
Author : N. Hiyashi,M.P. Manns,Marianne Manns,Nariyuki Hayashi
Publisher : Springer Science & Business Media
Page : 140 pages
File Size : 43,8 Mb
Release : 2004-07-21
Category : Medical
ISBN : 0792387961
In several liver diseases, the underlying cause cannot always be eliminated, i.e. the progression of liver disease cannot be prevented. This is particularly true for non-responders to the treatment of chronic hepatitis C (HCV). It is relevant for more than 40% of patients with HCV genotype 1 and up to 20% of patients with genotype 2 or 3. Several approaches are now underway to prevent or ameliorate mechanisms of disease progression. In Asia, and particularly in Japan, Glycyrrhizine-SNMC has been widely used for this purpose. At present, SNMC is under clinical evaluation in Europe. This book, the proceedings of the Falk Workshop on 'Prevention of Progression in Chronic Liver Disease - An Update on SNMC (Stronger Neo-Minophagen C)' (Part IV of the XII Falk Liver Week, in honour of Hans Popper's 100th birthday) held in Freiburg, Germany, on 22 October 2003, is devoted to the understanding of basic mechanisms of fibrogenesis, the state of the art of non-invasive markers of disease progression that may substitute liver biopsy in the future, and of other predictive parameters indicating disease progression, in particular the development of hepatocellular carcinoma. All these problems are particularly relevant for chronic hepatitis C. A better characterization of so-called non-responders for the treatments available is crucial for the development of new strategies preventing or postponing disease progression. Such strategies should influence fibrogenesis and, thus, cirrhosis formation as well as the development of life threatening complications of liver cirrhosis, including hepatocellular carcinoma. In this volume, the available information on SNMC as an approach to prevent progression of chronic liver disease is discussed by several internationally renowned authors who report on the mechanisms of liver fibrogenesis and fibrolysis, on non-invasive markers of disease progression, and on hepatocellular carcinoma as one of the major complications of liver cirrhosis nowadays. Finally, experts from Japan report on their knowledge and experience concerning the drug SNMC/Glycyrrhizine in the prevention of cirrhosis and HCC, and first study results from Europe are presented.
Author : Keith D. Lindor,E. Jenny Heathcote,Raoul E. Poupon
Publisher : Springer Science & Business Media
Page : 187 pages
File Size : 41,7 Mb
Release : 2012-12-06
Category : Medical
ISBN : 9789401148849
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.
Author : U. Leuschner,U. Broomé,A. Stiehl
Publisher : Springer Science & Business Media
Page : 424 pages
File Size : 43,8 Mb
Release : 2004-06-30
Category : Medical
ISBN : 0792387937
During the last decade, knowledge about cholestatic liver disease and concomitant diseases, such as ulcerative colitis, cholangio- and hepatocellular carcinoma, pancreas and colon cancer, has increased considerably. Studies on ursodeoxycholic acid treatment alone or in combination with immunosuppressive compounds and their positive effects on biliary liver disease as well as on so-called overlap syndromes or intestinal tumors are published in increasing numbers, and stimulate discussion on whether or not ursodeoxycholic acid is able to improve the general condition and/or life expectancy of patients. On the other hand, genetics, aetiological and pathogenetic aspects are still difficult to comprehend, but are the absolute prerequisite for the development of better treatment options. This book is the proceedings of Falk Symposium No. 136 (Part I of the XII Falk Liver Week, held in Freiburg, Germany, on October 15-16, 2003), and contains stimulating, exciting and controversial papers on clinical and also basic research at the highest scientific level.
Author : F. Berr,J. Bruix,J. Hauss,Ch. Wittekind,J. Wands
Publisher : Springer Science & Business Media
Page : 242 pages
File Size : 50,9 Mb
Release : 2002-11-30
Category : Medical
ISBN : 0792387791
Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC), both increasing in incidence, have become a major topic of basic and clinical research as well as clinical practice in hepatology. Experts in the field update the current concepts on the carcinogenesis of HCC and CC such as genetic alterations in the pathways of cell cylce and apoptosis regulation, the hypothesis of dedifferentiation of hepatocytes to the malignant phenotype vs that of activation of hepatic progenitor cells incapable of maturation (maturation arrest hypothesis). In spite of an increasing number of genetic alterations described in human HCC as well as cell regulatory pathways tested in experimental HCC models, the key hits causing progression of the cell cycle in imbalance with apoptosis, tissue invasive growth and metastatic potential of cell clones still remain elusive. Very powerful genomic and proteomic techniques are promising insights into the carcinogenesis of liver malignancies that will allow more efficient therapeutic strategies. The current concepts on risk profiling, surveillance of risk groups and therapeutic strategies are evidence-based for HCC and less detailed for CC. Surveillance of risk groups improves detection of liver tumours in curable stages. Best strategies for curative treatment of HCC use neoadjuvant antitumour therapies before liver transplantation and a role is emerging for living donor-related liver transplantation. New palliative therapies for HCC are in the experimental stage with biological response modifiers, including angiogenesis inhibitors, and entering phase II clinical trials with the alpha-fetoprotein derived vaccines.
Author : M. Lukás,M.P. Manns,J. Spicak,E.-F. Stange
Publisher : Springer Science & Business Media
Page : 338 pages
File Size : 48,5 Mb
Release : 2004-06-30
Category : Medical
ISBN : 0792387929
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.
Author : M.P. Manns,G. Paumgartner,U. Leuschner
Publisher : Springer Science & Business Media
Page : 426 pages
File Size : 40,6 Mb
Release : 2012-12-06
Category : Medical
ISBN : 9789401140003
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.
Author : H.E. Blum,Ch. Bode,J.Ch. Bode,R.B. Sartor
Publisher : Springer Science & Business Media
Page : 450 pages
File Size : 47,8 Mb
Release : 1998-02-28
Category : Medical
ISBN : 0792387368
This book, the proceedings of Falk Symposium 100, `Gut and the Liver', held in Freiburg, Germany, 29-31 May 1997, comprehensively reviews the physiological and pathophysiological interactions between the intestine and the liver as well as between intestinal and hepatic diseases. Apart from the basic aspects of the intestinal microflora and the immune system of the gut, gastrointestinal permeability and translocation as well as the contribution of the intestine and the intestinal bacteria to the metabolism of bile acids, amino acids and drugs are discussed. In addition, experimental as well as clinical data demonstrating the significance of gut-derived bacterial toxins for the development of liver diseases and the effect of liver diseases on gastrointestinal functions are discussed. The major aim of this book, therefore, is to highlight the interactions between gut and liver at the molecular level as well as in clinical disease.
Author : M. Campieri,G. Bianchi-Porro,C. Fiocchi,J. Schölmerich
Publisher : Springer Science & Business Media
Page : 270 pages
File Size : 50,7 Mb
Release : 1998-01-31
Category : Medical
ISBN : 0792387333
Most symposia on chronic inflammatory bowel disease during the last few years have focused on new aspects of aetiology and pathophysiology. However, based on such new aspects, changes in diagnosis and treatment have been developed over the last few years and some others are currently under investigation. This book, the proceedings of Falk Symposium 97, `Clinical Challenges in Inflammatory Bowel Diseases - Diagnosis, Prognosis and Treatment', held in Lugano, Switzerland, 18-19 April 1997, summarizes these changes and new developments, discusses their value and defines further new approaches. The topics include primary diagnosis, definition of different patient groups, special problems of these patients in daily life and very new therapeutic principles. This volume opens new possibilities of diagnosis and treatment of inflammatory bowel disease to physicians and provides stimulation for further development.
Author : Faruk Hadziselimovic
Publisher : Springer Science & Business Media
Page : 304 pages
File Size : 46,8 Mb
Release : 2002-09-30
Category : Medical
ISBN : 0792387783
This book is the proceedings of the Falk Symposium No. 127 on `Autoimmune Diseases in Paediatric Gastroenterology' (IV International Falk Symposium on Paediatric Gastroenterology), held in Basel, Switzerland, on November 8-9, 2001. The symposium focused on the role of the immune system, both the acquired and the innate systems, in inflammatory bowel disease (IBD) in children and adolescents. The innate system has an important fundamental role in host defence by initiating immune responses against potentially deleterious matter. However, a mutation within the innate system may elicit an immune response against the host: hence, an autoimmune response. Chronic autoimmune hepatitis occurs predominantly in young people, and especially in women. Immunological changes are conspicuous. Tissue antibodies are found in a large number of patients. This is a disease of disordered immunoregulation marked by a deficit in suppressor T cells causing the production of autoantibodies against specific hepatocyte surface antigen. Liver membrane protein is found in the sera of patients with autoimmune chronic acute hepatitis and with primary biliary cirrhosis (PBC). The latter condition of progressive granulomatous destruction of intrahepatic bile ducts is, in many respects, analogous to the graft-versus-host syndrome where the immune system has become sensitized to foreign HLA-molecules. Primary sclerosing cholangitis (PSC) is another condition of unknown origin. All parts of the biliary tree can be involved in a chronic, fibrosing, inflammatory process that results in obliteration of the biliary tree and ultimately in biliary cirrhosis. About half of the patients also suffer from ulcerative colitis and rarely from Crohn's disease. Circulating antibodies to some antigens are found in obstructed portal tracts, as well as increased concentrations of biliary immune complexes in patients with PBC. In all three previous Falk symposia on paediatric gastroenterology, attention was focused on the role of the innate immune system in the aetiology of IBD. It has become increasingly clear in recent years that the innate system has a much more important and fundamental role in host defence. The decision to initiate an immune response is one of the major roles of the innate system. Mutations within this system could transform it into becoming constitutively active, resulting in an inflammatory reaction and thus eliciting an autoimmune response. Following an introduction to the basic phenomena of autoimmunity, the proceedings discuss clinical aspects of autoimmune diseases. In particular, current knowledge and the state of the art about the diagnosis and treatment of the autoimmune diseases of the gastrointestinal tract are described by world-renowned experts. The book also contains the short presentations on selected topics, as well as abstracts of the mini-posters read by title, which were included in the symposium.
Author : K. Fellermann,D.P. Jewell,W.J. Sandborn,J. Schölmerich,E.-F. Stange
Publisher : Springer Science & Business Media
Page : 288 pages
File Size : 44,5 Mb
Release : 2001-06-30
Category : Medical
ISBN : 0792387678
The aetiology of the chronic inflammatory bowel diseases - Crohn's disease and ulcerative colitis - is still enigmatic. The therapeutic approach has therefore traditionally focused on anti-inflammatory principles, including corticosteroids and aminosalicylates. Since a significant proportion of patients is steroid-dependent or refractory and because of the problematic side-effects of long-term systemic steroids, active immunosuppression has gained acceptance in the field. The classical immunosuppressants azathioprine and 6-mercaptopurine have long been evidence-based in IBD, but underused. Recently, methotrexate and cyclosporine have also been proven to be effective in certain situations. Newer drugs like tacrolimus, mycophenolate and others may be similarly useful but their potential is still unclear. Finally, the immune modifiers including IL-10 and TNF-antibodies have been successfully subjected to controlled trials. Other experimental drugs discussed in this book are on the horizon. This volume is the Proceedings of Falk Symposium 119 held in Freiburg-im-Breisgau, Germany, October 3-4, 2000, and covers systematically the field of immunosuppression in inflammatory bowel diseases. It is hoped that it will further the prudent use of these drugs in the proper clinical situations by increasing our understanding of both the mechanisms of action and the clinical benefit to the patient.
Author : P. Rutgeerts,J-F. Colombel,S.B. Hanauer,J. Schölmerich,Guido Tytgat,A. van Gossum
Publisher : Springer Science & Business Media
Page : 340 pages
File Size : 48,7 Mb
Release : 1998-12-31
Category : Medical
ISBN : 0792387503
Ulcerative colitis and Crohn's disease remain a great therapeutic challenge to the medical community. In recent years knowledge about the pathogenesis of these diseases has progressed rapidly but the cause of the diseases remains completely unknown. It has become clear that dysregulation of the mucosal immune system is the basis for the chronic evolution of the diseases in a genetically susceptible population. Exciting new therapeutic approaches have been attempted in the last couple of years and cytokine and anti-cytokine treatments in particular seem very promising, especially in intractable disease. The format of the Falk Symposium 106 on `Advances in Inflammatory Bowel Diseases', held in Brussels, Belgium, June 18-20, 1998, was somewhat innovative as each session attempted to link the new insights into pathogenetic mechanisms with new therapeutic approaches, resulting in optimal information transfer. The classic therapeutic schemes were updated with a special focus on step-wise build-up of therapy.
Author : M. Acalovschi,G. Paumgartner
Publisher : Springer Science & Business Media
Page : 202 pages
File Size : 50,8 Mb
Release : 2001-03-31
Category : Medical
ISBN : 0792387708
In recent years, our knowledge about the pathogenesis, pathophysiology and treatment of hepatobiliary diseases has increased considerably. The molecular basis of cholestatic disorders as well as of gallstone disease is increasingly recognized. This has resulted in improved diagnosis, for instance in hereditary forms of intrahepatic cholestasis, and advances in treatment, for example in primary biliary cirrhosis and other chronic cholestatic disorders. This book, the proceedings of a Falk Workshop held in Cluj-Napoca, Romania, on June 9-10, 2000, brings together contributions from scientists and clinicians to highlight the most recent advances in molecular biology, pathophysiology, diagnosis and therapy of diseases of the hepatobiliary system. World experts cover a broad spectrum of topics from genetic studies to endoscopy and from medical treatment to liver transplantation.
Author : D. Rachmilewitz,R. Modigliani,D.K. Podolsky,D.B. Sachar,N. Tozun
Publisher : Springer Science & Business Media
Page : 266 pages
File Size : 40,7 Mb
Release : 2002-06-30
Category : Medical
ISBN : 0792387732
This book, the proceedings of Falk Symposium No. 123, VI International Symposium on Inflammatory Bowel Diseases, held in Istanbul, Turkey, on September 3-5, 2001, focuses on the issues and controversies pertinent to IBD in the 21st century. The achievements in medical, surgical, and in the basic sciences in the last twenty years since the first Jerusalem IBD Symposium are summarized in detail. Controversies with respect to the medical treatment of inflammatory bowel diseases are discussed. One section deals with surgical issues such as laparoscopic surgery in inflammatory bowel diseases, ileo-anal pouches and the surgical treatment of Crohn's disease. The last section is devoted to the biological treatment of IBD and to the needs both in medical science and in the clinic.