Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
Surgical techniques for gastroesophageal reflux disease (GERD) have improved in recent years. This viewpoint considers the evidence in favor of surgical therapy as an alternative to medical therapy for GERD. The safety and clinical efficacy of surgery has been demonstrated, particularly in patients with Barrett's esophagus and those with GERD-related respiratory symptoms.
Endoscopic antireflux procedures are an alternative treatment for patients who do not desire medical therapy for gastroesophageal reflux disease. This Viewpoint assesses the success rates of endoscopic therapies and highlights the importance of selecting appropriate patients for this therapy.
In 2002, the United Network for Organ Sharing introduced the model for end-stage liver disease (MELD)/pediatric end-stage liver disease (PELD) organ allocation system. This Review discusses the history of donor liver allocation in the US, the development of the MELD/PELD allocation system, its success so far and its shortcomings, and the need to optimize the donor organ pool.
Two new types of imaging technology—laser-scanning confocal endoscopy series and contact endoscopy series—could reduce the number of biopsies that need to be taken by enabling anin vivo'virtual' histological diagnosis. Although it is currently not clear which technology should be adopted, microscopic evaluation of living tissue is now a reality.
Over the past 20 years the applications of endoscopic ultrasound (EUS) have expanded, with real-time EUS-guided fine-needle aspiration and fine-needle injection now possible. This Review describes the current clinical status of EUS in gastrointestinal oncology, possible future and novel indications and therapeutic strategies.
The histologic spectrum of nonalcoholic fatty liver disease extends from isolated hepatic steatosis to steatohepatitis. Its pathogenesis is linked to insulin resistance and underlying metabolic syndrome. This Review discusses the physiologic basis for hepatic lipid homeostasis, its disturbance in insulin resistance and the genesis of nonalcoholic fatty liver and nonalcoholic steatohepatitis.
