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Basic research has led to rapid progress in understanding the mechanisms underlying hepatic fibrosis. Fibrogenic hepatic cell types have been characterized, as have general and disease-specific mechanisms. Studies also indicate that hepatic fibrosis is reversible. The impact of this work on clinical practice is that treating hepatic fibrosis is now emerging as a real possibility.
Our understanding of carcinogenesis in Barrett's esophagus has markedly increased in the past decade, thanks to the close interaction of clinicians, epidemiologists and basic scientists. This review discusses how reflux of gastroduodenal contents, dietary habits, obesity, upper gastrointestinal infections and exposure to carcinogens might contribute to the development of cancer in Barrett's esophagus.
During the past few years there has been renewed interest in the management of chronic anal fissure. Treatment with botulinum neurotoxin is less expensive and easier to perform than surgery and does not require anesthesia. It is also more efficacious than nitrate therapy and is not related to the patient's willingness to complete treatment.
Gallstone disease continues to be a significant problem. The recent identification of mouse genes may help determine susceptibility to the disease. An infectious etiology hypothesis has also been proposed to explain the development of gallstones. Could these discoveries lead to more effective strategies for the prevention and treatment of gallstones?