Download e-book for iPad: Biliary Lithiasis: Basic Science, Current Diagnosis and by Giuseppe (EDT)/ Cordiano, Claudio (EDT) Borzellino

By Giuseppe (EDT)/ Cordiano, Claudio (EDT) Borzellino

ISBN-10: 8847007623

ISBN-13: 9788847007628

The booklet provides an assessment on biliary lithiasis and all its medical photographs, two decades after the 1st laparoscopic cholecystectomy. The gallbladder, the most bile duct and intra-hepatic stones, of their basic and intricate forms are illustrated. Chapters are all in favour of uncomplicated technology, epidemiology, diagnostic and healing approaches to biliary lithiasis. the several diagnostic tactics defined contain  invasive and noninvasive imaging,  and remedies think about clinical therapy, open and minimally invasive surgical procedure, endoscopic and percutaneous ways, either individually and as mixed procedures.  The book's content material is not constrained to the most more often than not used therapeutic methods suggested within the literature, but also addresses new and cutting edge healing concepts for biliary lithiasis. due to its entire process, this quantity can be of curiosity not just for GPs amd experts during this box, but in addition to citizens and different doctor of alternative disciplines.

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Additional info for Biliary Lithiasis: Basic Science, Current Diagnosis and Management

Sample text

They are mainly bilirubin conjugates with traces of porphyrins and unconjugated bilirubin. In humans, bile pigments include bilirubin, mono- and diglucuronides predominating: invariably present are other mono- and diconjugates of xylose, glucose, and glucuronic acid as homo- and heteroconjugates. Bile salts are highly soluble, being detergent-like amphiphilic molecules; the hydrophilic (polar) areas of bile salts are the hydroxyl groups and conjugation side chain of either glycine or taurine and their hydrophobic (nonpolar) area is the ringed steroid nucleus.

Specifically, the bile acid receptor farnesoid X receptor (FXR) [40–42] and the oxysterol receptor liver X receptors (LXRs) [43, 44] drive gene transcription of lipid canalicular transporters. FXR promotes the expression of bile salt transporter ABCB11 [45] and phospholipid transporter ABCB4 [46]; LXR is responsible for the transcription of cholesterol transporters ABCG5 and ABCG8 [47]. Nuclear receptors share a common molecular structure: the C-terminal ligand-binding domain (LBD) contains an hydrophobic pocket that selectively recognizes and binds the ligand, resulting in a change of the three-dimensional structure of the nuclear receptor, which is now capable of starting gene transcription through the DNA binding domain (DBD).

ABCB11 is the gene mutated in type 2 progressive familial intrahepatic cholestasis (PFIC2), an homozygous disorder characterized by onset in the first years of life, progressive behavior, and a poor prognosis, leading to liver failure before adulthood. Homozygous disruption of the Abcb11 gene in knockout mice results in severe impairment of bile flow, with total bile acid output as low as one-third of that in wild type mice, with a dramatic reduction of cholic acid secretion and only mild or no change for the remaining bile salts species [36].

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Biliary Lithiasis: Basic Science, Current Diagnosis and Management by Giuseppe (EDT)/ Cordiano, Claudio (EDT) Borzellino

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