The contributions to this volume cover all aspects of the assessment and management of hepatobiliary disease. The focal points of the book consist of three state-of-the-art summaries. The first of these deals with the highly topical problem of liver transplants from the point of view of patient selection. The second considers drug-induced liver injury in view of the fact that the liver is the main metabolic site for a number of drugs. The final summary deals with liver and aging: it asks whether the liver follows the aging process of the host organisms and whether the liver of aged liver transplant candidate donors could be suitable for grafting. Aside from these topics, the volume presents basic research on hepatic transport mechanisms, intrahepatic cholestasis and gall-stone disease, which serves as a background for the topics more specifically concerning the assessment of liver function. Much of the book is then devoted to the management of the commonest forms of liver diseases and their complications, such as chronic active hepatitis, liver cirrhosis, portal hypertension, hepatic encephalopathy, hepatorenal syndrome, and ascites.

The liver is an exceptionally complex and diverse organ that functions both as an exocrine and an endocrine gland. It secretes bile, which contains many con stituents in addition to bile salts, and it synthesizes and releases many substances in response to the body's demands, including prohormones, albumin, clotting factors, glucose, fatty acids, and various lipoproteins. It has a dual blood supply providing a rich mixture of nutrients and other absorbed substances via the portal vein and oxygen-rich blood via the hepatic artery. This functional heterogeneity is accompanied by cellular heterogeneity. The liver contains many cell types including hepatic parachymal cells, Kiipffer cells, Ito cells, and endothelial cells. The most abundant cell type, the parenchymal cells, are biochemically and structurally heterogeneous. The cells in the oxygen-rich areas of the portal triad appear more dependent on oxidative metabolism, whereas those around the central vein (pericentral, perivenous, or centrolobular areas) are more dependent upon an anaerobic mechanism. Throughout this volume the latter three terms are used synonymously by various authors to indicate the five to eight layers of cells radiating from the central vein. Structural and metabolic heterogeneity of hepatic parenchymal cells has been demonstrated by a variety of approaches, including histochemical, ultra structural, and ultramicrobiochemical studies. This microheterogeneity is linked to the physiological functions of the liver and its response to injurious substances.

The Twelfth Annual Midwest Conference on Endocrinology and Metabolism continued the tradition of selecting a topic of inter est to a wide variety of scientists with interests in biology. The conference an "Hormones and Energy Metabolism" was dedicated appro priately to Dr. Samuel A. Brody, a leader in research in this field as described by Professor Johnson in this volume. A particular feature of these conferences has been the large proportion of time devoted to discussion of each paper and the pub lished proceedings have included edited transcripts of these dis cussions. Unfortunately, due to malfunction of the recording sys tem, major portians of the discussions were lost and, despite much effort, insufficient was salvageable tobe meaningful and helpful. Consequently, the editors decided to omit completely the discus sions except for a communication provided by Dr. Woodside. We again express our appreciation to the staff of Conferences and Short Courses, University of r~issouri-Columbia Extension Divi sion and especially to Dr. John Swanson who helped organize the multitude of administrative details; to ~lrs. Linda Bennett, CPS, for her continuing excellent efforts in typing the manuscripts for publication; and particularly to the sponsors, without whom there would have been no conference. Ralph R. Anderson f·1urray Heimberg David r~. Klachko vii CONTENTS Dedication: Dr. Samuel A. Brody xi Brody Memorial Lecture: Same Aspects of Energy Coupling by Mitochondria ...