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Laboratory of Molecular Diagnostics, Wadsworth Center for Laboratories and Research, New York State Department of Health, and the School of Public Health, State University of New York at Albany, Albany, NY 12201-0509. E-mail r.rej{at}albany.edu
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Introduction |
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 Top Introduction References |
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The human liver performs diverse functions essential for life. Monitoring specific hepatic functions by laboratory methods provides clinicians essential insight regarding the integrity of the liver (1)(2). Beyond the procedures that have been in the standard armamentarium of the clinical laboratory for decades, the applications of techniques provided by molecular biology are now in routine use. Howard Worman of Columbia University has provided an insightful introduction to these techniques that allow the diagnosis of viral, metabolic, and autoimmune hepatic disorders.
Hepatitis and other liver diseases are prevalent health problems. Nearly 50 000 cases of viral hepatitis were officially reported in the US in 1995 (3), and nearly 300 000 cases are estimated to actually occur annually (4). Similar incidences and presumed high rates of unreported cases of hepatitis have been observed in Germany (5) and France (6). Several currently identified hepatotropic viruses are associated with a wide spectrum of acute and chronic liver disease syndromes. The modes of action and molecular diagnostics of each of these hepatitis viruses were comprehensively reviewed in a series of presentations by Busch, Lemon, Gitlin, and Urdea—all of whom emphasized both new and well-recognized laboratory techniques in the support of the patient with hepatitis. Busch also covered the laboratory's essential contributions to reducing the risk of posttransfusion hepatitis.
Laboratorians continue to search for accurate and reliable methods to quantify hepatic functions, particularly by means of model drugs that are metabolized exclusively by the liver by cytochrome P450 enzyme systems. The application and limitation of these function tests were presented by George Lambert with a particular emphasis on noninvasive laboratory procedures. Excess consumption of ethanol is also a well-recognized public health issue. Recent advances in the mode of action of ethanol, quantification of hepatic damage by laboratory methods, and current therapeutic approaches were presented by Michael Laposta.
Liver cancer may be induced by viral hepatitis or cirrhosis. The pathogenesis of liver cancer was presented by Emanuel Rubin (presentation not included in these proceedings). Hemochromatosis and Wilson disease are important inherited disorders that cause acute and chronic liver disease. The laboratory's role in the recognition, investigation, and screening for these diseases was presented by David Witte, who convinced us that laboratory screening for hemochromatosis, once thought to be a rare condition, provides significant benefit.
Liver transplantation has emerged as a realizable treatment for both end-stage chronic liver disease and acute liver failure. The important role of the laboratory, in particular to aid the selection of patients for transplantation and the support of the patient after liver allografts, was presented by Hickman and Shaked.
Given the large number of laboratory tests available for the diagnosis and estimating severity of liver diseases, the Conference concluded with Edgar Black's examination of testing algorithms and strategies for the cost-effective application of laboratory procedures in support of the patient with liver disease. Two parallel breakout sessions were also featured, with case presentations by Conference Committee members covering specific cases representative of the major themes of the Conference.
The generosity of the Arnold and Mabel Beckman Foundation makes possible this series of meetings and their proceedings. The clinical laboratory community owes a continuing debt of gratitude to Dr. Beckman's foresight in establishing these annual conferences. It was my pleasure to serve as Chair of the Proceedings of the 20th Arnold O. Beckman Conference Organizing Committee for the Twentieth Conference and as Guest Editor of these proceedings. I hope that this published record serves as an accurate account of the conference and further disseminates the information presented to all the readers of Clinical Chemistry.
Now beginning its third decade, the Arnold O. Proceedings of the 20th Arnold O. Beckman Conference in
Clinical Chemistry has established itself as an annual forum for
in-depth exploration of important topics at the clinician–laboratory
interface. In establishing the Conference it was Dr. Beckman's vision
that it should have an impact far beyond the Conference itself. Each of
the 20 meetings' proceedings has been published, and since 1986, in
the pages of this journal (Table 1
). In 1995, the Conference Committee had the collected
Proceedings bound; these were presented to Dr. Beckman later that year
by Peter Wilding, then AACC President (Fig. 1
). This published legacy serves as a chronicle of the
development of the science of clinical chemistry and of topics that
form either the forefront or the mainstay of the discipline (Table 1
).
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Acknowledgments |
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References |
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TopIntroductionReferences |
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The following articles in journals at HighWire Press have cited this article:
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  E. R. Ashwood Acute coronary syndromes: from bench to bedside–the Twenty-first annual Arnold O. Beckman Conference in Clinical Chemistry Clin. Chem., August 1, 1998; 44(8): 1795 - 1797. [Full Text] [PDF]
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R. Rej Liver diseases and the clinical laboratory—the Twentieth Arnold O. Proceedings of the 20th Arnold O. Beckman Conference in Clinical Chemistry Clin. Chem., August 1, 1997; 43(8): 1473 - 1475. [Full Text] [PDF]
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