Fifty years of impact on liver pathology: a history of the Gnomes.

Professional societies play a major role in medicine and science. The societies tend to be large with well-developed administrative structures. An additional model, however, is based on small groups of experts who meet regularly in an egalitarian model in order to discuss disease-specific scientific and medical problems. In order to illustrate the effectiveness of this model, the history and practices are examined of a long-standing successful example, the International Liver Pathology Group, better known as the Gnomes. The history shows that groups such as the Gnomes offer a number of important benefits not available in larger societies and nurturing such groups advances science and medicine in meaningful ways. The success of the Gnomes' approach provides a road map for future small scientific groups.

Data on Adiponectin from 2010 to 2020: Therapeutic Target and Prognostic Factor for Liver Diseases?

The review describes the role of adiponectin in liver diseases in the presence and absence of surgery reported in the literature in the last ten years. The most updated therapeutic strategies based on the regulation of adiponectin including pharmacological and surgical interventions and adiponectin knockout rodents, as well as some of the scientific controversies in this field, are described. Whether adiponectin could be a potential therapeutic target for the treatment of liver diseases and patients submitted to hepatic resection or liver transplantation are discussed. Furthermore, preclinical and clinical data on the mechanism of action of adiponectin in different liver diseases (nonalcoholic fatty disease, alcoholic liver disease, nonalcoholic steatohepatitis, liver cirrhosis and hepatocellular carcinoma) in the absence or presence of surgery are evaluated in order to establish potential targets that might be useful for the treatment of liver disease as well as in the practice of liver surgery associated with the hepatic resections of tumors and liver transplantation.

Pathology of liver disease: advances in the last 50 years.

Liver disease has been recognized in various forms for centuries. Incredible advances, however, have been made especially in the last 50 years, driven by improvements in histology, the development of immunostains, the development of high resolution imaging methods, improved biopsy and resection methods, and the emergence of the molecular era. With these tools, pathologists and their clinical and basic science colleagues moved from classifying liver disease using an observational, pattern-based approach to a refined classification of disease, one based on etiology for medical disease and tumor classification for neoplastic disease. Examples of liver specific diseases are used to illustrate these exciting advances. These impressive advances of the past provide the foundation for hope in the future, as liver pathology continues to play an important role in improving patient care through disease identification and classification and emerging roles in guiding therapy for cures.

Congress presidential address to the 30th meeting of the JSHBPS: the second opening of Japan on the way to a bright future.

The 30th meeting of the JSHBPS is the first domestic meeting of our society to have been organized completely in English. In that sense, we have established the theme of the 30th meeting of the JSHBPS as "The Second Opening of Japan on the Way to a Bright Future". Last 30 years, several strategies have been undertaken to battle hepatobiliary (HPB) malignancies, such as aggressive operative procedures, operative planning using state-of-the-art technologies, neoadjuvant therapy, conversion surgery for initially unresectable diseases, and immunomodulation. According to the rapid development of precision medicine, HBP surgeons should have a literacy for individualized therapy. Here, I review recent improvements in regard to HBP surgery. In addition, education for the next generations should be our highest priority. Collaboration with foreign researchers is the most effective tool to promote personal growth.

Present, Past,and Future of the Latin American Association for the Study of the Liver- Asociación Latinoamericana para el Estudio del Higado (ALEH).

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Contributions of Magnetic Resonance Imaging to Gastroenterological Practice: MRIs for GIs.

MRI has transformed from the theoretical, investigative realm to mainstream clinical medicine over the past four decades and has become a core component of the diagnostic toolbox in the practice of gastroenterology (GI). Its success is attributable to exquisite contrast and the ability to isolate specific proton species through the use of different pulse sequences (i.e., T1-weighted, T2-weighted, diffusion-weighted) and exploiting extracellular and hepatobiliary contrast agents. Consequently, MRI has gained preeminence in various GI clinical applications: liver and pancreatic lesion evaluation and detection, liver transplantation evaluation, pancreatitis evaluation, Crohn's disease evaluation (using MR enterography) rectal cancer staging and perianal fistula evaluation. MR elastography, in concert with technical innovations allowing for fat and iron quantification, provides a noninvasive approach, or "MRI virtual liver biopsy" for diagnosis and management of chronic liver diseases. In the future, the arrival of ultra-high-field MR systems (7 T) and the ability to perform magnetic resonance spectroscopy in the abdomen promise even greater diagnostic insight into chronic liver disease.

Chapter 6.0. History of Paediatric Hepatology in ESPGHAN.

Hepatology played an important role in ESPGAN from the beginning. In 1989, the Hepatology Committee was started. In the early 1990s H for hepatology was included in ESPGHAN. Hepatology Summer schools were held from 1995 and later monothematic conferences met the needs of many young ESPGHAN members. The role of ESPGHAN members in the progress of diagnostic and therapeutic measures in hepatitis B and C will be elucidated (Chapter 6.1) as well as the role of other ESPGHAN members in the understanding of immunological hepatic disorders of childhood (Chapter 6.2). During childhood, many metabolic hepatic disorders threaten the life and health of children making orchestrated measures in diagnostic and therapeutic efforts necessary (Chapter 6.3). The pathophysiology of cholestasis was cleared by the detection of bile salt transporters, which were identified by ESPGHAN members in the Netherlands, France, United Kingdom and Germany (Chapter 6.4). Finally liver transplantation for acute fulminant and chronic end stage liver disease was established as a meanwhile standard treatment option (Chapter 6.5). Immunosupression in liver transplantation was improved and standardized through the cooperation of many ESPGHAN member driven studies (Chapter 6.6).

Hepatobiliary Hands of Hopkins.

OBJECTIVE: This historical perspective documents the role that John L. Cameron played in advancing hepatobiliary research, education, and surgery at Johns Hopkins in the 1970s, 1980s, and 1990s. SUMMARY OF BACKGROUND DATA: Dating back to William S. Halsted in the 19th century, leaders of the Department of Surgery at Johns Hopkins have been interested in hepatobiliary disease and surgery. John L. Cameron had broad hepato-pancreato-biliary (HPB) interests when he completed his surgical training. Over the next 3 decades, he focused on the pancreas. As a result, many faculty and trainee hepatobiliary careers were launched. METHODS: This perspective is based on 18 years of service as a surgical resident and faculty member at Johns Hopkins. An extensive literature search on the hepatobiliary publications of Halsted, Trimble, Blalock, Longmire, Zuidema, and Cameron was undertaken for this manuscript. Numerous hepatobiliary publications from Johns Hopkins from the 1970s, 1980s, 1990s, and early 2000s were also reviewed. RESULTS: John L. Cameron's early biliary interests included stones, infections, malignancies, and strictures. He was innovative with respect to portal hypertension and Budd-Chiari surgery and supportive when liver transplantation emerged in the 1980s. Volume-outcome studies in the 1990s included hepatic and complex biliary surgery. He supported and encouraged studies of biliary lithotripsy, laparoscopic cholecystectomy, clinical pathways, hepatobiliary cysts, and gallstone pathogenesis. CONCLUSION: Lessons learned by many who worked with John L. Cameron included the importance of mentorship, innovation, friendship, and collaboration. He taught leadership and change management by example. He fostered a multidisciplinary approach and encouraged randomized controlled trials.

Pathology of the liver in children: Where would I (we) be without "Pepper"?

A tribute to Pepper's lasting contributions to Hepatopathology.

A panoramic view of chronic liver diseases and natural remedies reported in Traditional Persian Medicine.

Regarding limited effectiveness of many hepatic medical approaches, seeking for novel treatment strategies is crucial to improve outcomes. Hence, the current study aims to compile a concise but critical review over reported liver diseases and related medicinal plants from the Persian medicine perspectives. To this end, five main pharmaceutical manuscripts of Persian medicine from 9th-18th A.D. as well as the latest and largest medical textbook of Persian medicine were studied. By searching through databases such as PubMed and ScienceDirect, mechanisms or pharmacological activities of reported medicinal plants in the field of liver diseases were cited and discussed. In all, seventeen different liver diseases, mainly chronic, were cited in Persian medicine. Ninety three medicinal plants with liver tonic, hepatoprotective and related effectiveness belonging to 49 families were derived and authenticated from these studied manuscripts. More than 75% of the herbs showed related hepatoprotectivity and antioxidant activities. However, none of them have been examined clinically. Besides historical clarification, the current investigation compiled an evidence- based study on reported liver herbal remedies from the standpoints of Persian scholars. Conducting attributable clinical trials against the backdrops of proven in vitro and in vivo studies may result in new treatment discoveries for liver diseases.