Register early, receive discounts
AASLD 2009 program focuses on viral hepatitis and NASH
Lectures highlight cutting-edge therapies, critical issues in liver diseases
AGA offers hot topics from the clinic and the lab
Nobel laureate shares research on protein degradation and drug targeting
ASGE's 2009 offerings have something for everyone, every hour
Masters Series Course teaches deep-small bowel endoscopy
More video sessions among increased SSAT program offerings
SSAT panel to discuss issues related to genetic testing



Register early, receive discounts

Take advantage of early bird discounts by registering now for DDW®. It saves you money, allows you to arrange for the hotel of your choice, secures your space in ticketed sessions and eliminates the need to spend time at on-site registration. You can save $100 by registering before April 24.

The easiest and fastest way to register is online at www.ddw.org. DDW attendees who register by May 8 will receive their registration materials in the mail. Attendees whose registration is received on or after May 9 must pick up their registration materials at McCormick Place, South Hall, from noon to 8 p.m. Friday, May 29; 7 a.m. to 6 p.m. Wednesday, June 3; or from 7:30 a.m. to 5 p.m. Thursday, June 4 (ASGE postgraduate course only).

DDW registration fees

The association's role at DDW® is to bring to GI clinicians and allied health professionals "advances occurring both at the bench and at the bedside that will affect the health of their patients with liver disease," said AASLD President Scott L. Friedman, MD, chief of the liver diseases division at Mount Sinai School of Medicine in New York.

In light of this, AASLD has organized many of its clinical symposia around the two major diseases and co-morbidities that GI clinicians most often confront — viral hepatitis and non-alcoholic steatohepatitis.

Two symposia will be offered on the latest advancements in therapies for both hepatitis B and C, including Avoiding HBV Drug Resistance: How Many Drugs? on May 31 and HCV: New Frontier for Therapies on June 1.

"From the clinical perspective, viral hepatitis therapies are advancing extremely rapidly — in particular the new generation of protease and polymerase inhibitors that, when combined with current interferon/ribavirin therapy, will greatly improve the response for hepatitis C," Dr. Friedman said.

"Equally exciting has been the establishment of new agents for hepatitis B and the challenge of determining how to minimize resistance, and whether this requires using multiple drugs at once because of the way treatment paradigms for HIV have evolved."

The June 2 Clinical Symposium, Novel Diagnostics in Liver Disease, will examine noninvasive diagnostic protocols being developed to avoid liver biopsies, "which capture only 1/50,000th of the total organ and which everyone recognizes are relatively invasive," Dr. Friedman said.

"There's been a sense of urgency in developing noninvasive markers of liver disease, such as blood or imaging tests that will offer as much or more information than a biopsy and track changes in disease activity or fibrosis over time, say in response to a drug in a clinical trial," he said.

The symposium also will look at new frontiers in defining genetic risk markers for liver disease.

"We can now define genetic markers to predict whether or not a patient, say with chronic hepatitis C, is at risk for progressing to cirrhosis even when their liver, at any given moment, is not terribly fibrotic," Dr. Friedman said. "The challenge is how do we use that information to optimize patient care and tailor treatment?"

Further symposia on tap for 2009 include the annual AASLD/NASPGHAN Pediatric Symposium, Cystic Fibrosis: Liver Disease in the 21st Century, May 31. In addition, Therapeutic Advances in Acute Liver Failure will be offered June 1 and Approaches to Weight Loss in NASH, a discussion of weight-loss approaches for patients diagnosed with the obesity-related liver disease, NASH, will be presented June 2.

AASLD also will participate in the DDW Combined Clinical Symposium on June 1, Hepatic Resection for Liver Masses. This session will deal with the growing challenge of managing hepatocellular carcinoma (HCC) and the development of treatment protocols.

"Hepatocellular carcinoma is the fastest rising malignancy in the western world and the third-leading cause of cancer death worldwide," Dr. Friedman said.

"We have just entered into a new treatment era in the last year with the emergence of a new oral, targeted molecular therapy for HCC (sorafenib), which may still be complemented by hepatic resection in appropriately selected patients who have stable liver function, and who will benefit from removing the mass instead of administering chemotherapy or listing for transplantation. This symposium will focus on these important considerations," he said.

Finally, for the first time during DDW, AASLD will offer a clinical trial endpoints workshop May 30.

Experts participating in the ticketed NAFLD Endpoints Workshop will work to reach consensus on defining criteria for determining NAFLD therapy success in clinical trials. Though not directed primarily at GI clinicians, the endpoints workshop is "intended for people who really want to understand the leading edge of clinical trial design in this disease," Dr. Friedman said.

Several companies are developing or testing new drug therapies for NAFLD, a disease without any specific, approved treatments, Dr. Friedman said.

"We need to be leaders in defining how those drugs should be adequately tested so the results from one trial are comparable to those from another."

Each year AASLD State-of-the-Art (SOA) Lectures bring the most critical issues and cutting-edge research in liver disease management to DDW®. This year, SOA Lectures feature one of hepatology's top transplantation experts, who will address the urgent need to expand the liver donor pool.

Along with liver transplantation topics, lectures will be offered addressing liver disease co-morbidities and the latest developments in viral hepatitis therapies as well as examining the emerging information surrounding the liver's impact on immune response.

Transplantation expert Douglas W. Hanto, MD, PhD, will talk about enlarging the pool by including organs from donors whose hearts have stopped beating, in his May 31 lecture, Donors after Cardiac Death (DCD) for Liver Transplantation: Will it Address the Donor Shortage?.

Current requirements only allow consideration for liver donation of individuals declared brain-dead, but whose heart remains beating. The growing number of patients on the liver transplantation waiting lists in the U.S. however, is an issue requiring the consideration of once unappealing or unacceptable options, said AASLD President Scott L. Friedman, MD.

"There is an accelerating sense of urgency to provide more organs in whatever way is safe and ethically responsible," said Dr. Friedman. "Each year, the number of patients with advanced liver disease waiting for organs increases, while the number of patients dying while waiting for a transplant grows."

In the U.S., there are only two options for enlarging the donor pool, said Dr. Friedman, chief of the Division of Liver Diseases at Mount Sinai School of Medicine in New York.

"One way is to increase the number of cadaveric donors either by enhanced awareness of organ donation or the use of donor pools once considered unacceptable, like DCD. The other way is through living donor transplantation, which remains a small fraction of the total number of liver transplants performed in this country."

Arun J. Sanyal, MD, will also address transplantation-related issues in the June 1 lecture, Hematologic Complications of Chronic Liver Disease and Transplantation.

AASLD brings to DDW important lectures on issues of liver disease management that GI practitioners are most likely to see in their patients, Dr. Friedman said. One increasingly prevalent condition closely tied to obesity is non-alcoholic steatohepatitis (NASH).

A part of the metabolic syndrome, NASH is a disease that disproportionately affects the liver. But NASH has many competing morbidities, a topic to be discussed in the June 1 session, NASH and Co-Morbidities, presented by Brent Tetri, MD.

"The metabolic syndrome, of which NASH can be a feature, is typically classified by the presence of insulin-resistant obesity, hypertriglyceridemia and hypertension," Dr. Friedman said.

"GI and liver specialists must be cognizant of the co-morbidities of NASH and the many non-liver risks, such as cardiovascular disease, facing their patients," he said. "So unlike viral hepatitis, one cannot focus solely on the liver in patients with NASH."

Just as hepatologists are learning more about the impact of obesity on the liver, researchers are increasingly looking at the importance of the liver in the immune system. Gyongyi Szabo, MD, PhD, will address this burgeoning area of discovery in the lecture June 2, Liver Immunology Update: The Unfolding Mysteries.

"The liver immune system is in fact very mysterious and has been largely overlooked — even among immunologists — for many decades," Dr. Friedman said. "And what we're learning is that the liver immune system has some very unique properties that are not present in other organs or in the circulating immune system."

These properties include the liver's enhanced ability to clear infections and microbes from the body and essentially block the dissemination of bacteria entering the body from the intestines. The liver also has a unique immunologic response to alcohol.

"Interestingly enough, despite our very clear recognition that alcohol is a liver toxin that can lead to severe disease, including cirrhosis and death, we still have a lot to learn about the mechanisms underlying alcoholic liver disease. And increasingly it's clear that the immune response is among the most critical pathways that precipitate alcoholic liver disease," Dr. Friedman said.

Recent developments in hepatitis C therapies will be discussed May 31 by Donald M. Jensen, MD, in his session, HCV Therapy Advances: Today and Tomorrow. He will discuss clinical trials of new therapies and possible impacts of new therapies on outcomes.

New HCV therapies, such as protease and polymerase inhibitors, show great promise for improving HCV response, especially when used in combination with current therapies, Dr. Friedman said.

In keeping with the AGA's history of offering high quality, clinical education balanced with innovative sessions on scientific discovery in gastroenterology, the AGA once again offers an exciting DDW program featuring experts discussing hot topics in the clinic and the lab.

"We have some very exciting, high-quality medical and scientific symposia planned for this year. There is something for everyone," said AGA Institute Council Chair Sheila E. Crowe, MD, AGAF.

"If you're in clinical practice, there will be lots of invited-speaker symposia that will provide overviews on topics like inflammatory bowel disease, liver disease, and everything that complicates acid reflux disease. If someone is researching Helicobacter pylori (H. pylori) infection, which many people around the world are still doing, there will be a session on H. pylori infection. There will be lots of Research Posters and Oral Sessions from different investigators from around the world," she said.

Other highlights of AGA's planned offerings this year include a novel Presidential Plenary, a special program on women and gastrointestinal health, and a lecture by a Nobel laureate in chemistry.

"Many of our presentations are related to signaling and other mechanisms of cell biology, including those related to the development of cancer," said Dr. Crowe, professor of medicine at the Digestive Health Center of Excellence, University of Virginia, Charlottesville. "While the theme wasn't intentional, it does reflect some of the key science that is going on in the specialty of digestive diseases."

Presidential Plenary
This year's AGA Presidential Plenary promises attendees a new experience. AGA Institute President Robert S. Sandler, MD, MPH, AGAF, has invited a selection of experts to each give 10-minute overview talks on hot clinical topics and the future of GI.

"I think it's something novel, at least in my 22 years of attending DDW," Dr. Crowe said. "These presentations are going to be short sound bites from experts. I think it's going to be fast-paced and give people an overview of some important areas and new directions in the field of gastroenterology and hepatology. I think it will be a great way for attendees to get an update."

Topics for the overview talks will include:
• Which Basic Science Breakthroughs of Today Will Impact Patient Care of the Future?
• Can We Do a Better Job Preventing Colon Cancer?
• Quality Assessment and Pay-For Performance: Will Gastroenterologists Take Home a "Report Card"?
• Endoscopic Ablation in Barrett's: Who Needs It, and What Weapon?
• What is the Role of the Gastroenterologist in Treating Liver Cancer?
• How Will We Train the Gastroenterologist of the Future?
• How Do We Balance the Risks, Benefits and Costs of Various Treatment Strategies for IBD?
• NOTES: Is the Future of Endoscopy in the Lumen or the Peritoneum?

In addition, the Basic Science Plenary will showcase presentations focused on the theme of bacterial innate interactions in the intestine, while the Clinical Science Plenary will showcase presentations primarily concerned with colorectal cancer screening, prevention and treatment.

Spring Postgraduate Course
The 2009 AGA Institute Spring Postgraduate Course, Applying New Evidence to Clinical Practice, on May 30 and 31, will offer a look at the state of the art in GI practice based on the latest clinical research.

Directed by Nicholas J. Shaheen, MD, MPH, AGAF, the two-day, multi-topic course will focus on six main areas of the field: GI malignancy, esophageal diseases, IBD, functional bowel disease, liver disease and pancreaticobilary diseases. Course co-directors are Douglas K. Rex, MD, and Michael B. Wallace, MD, MPH, AGAF.

Each session also will feature an Endoscopists' Corner Lecture, where leading experts in the field of endoscopy will highlight common and new areas of endoscopic practice, including methods for ablative therapy in Barrett's esophagus, managing recurrent esophageal strictures, preventing IBD-associated colorectal cancer and variceal bleeding and the role of capsule endoscopy in screening functional bowel diseases.

A separate registration fee is required for this course.

Women's Committee Special Program
The AGA Institute Women's Committee will introduce a new AGA instructional slide set on women's GI health in its special program titled Digestive Diseases and Health in Women, June 2. The event is co-sponsored by the AGA Education and Training Committee.

Speakers will be GastroSlides authors Jennifer A. Christie, who will address "Colon Cancer in Women;" Asma P. Khapra, who will discuss "Fecal Incontinence and Endometriosis of the GI Tract," and Rebecca W. Van Dyke, who will talk about "Pregnancy and Liver Disease."

"IBS is a major cause of GI symptoms in the female population and then there are other related disorders like pelvic floor dysfunction and fecal incontinence that largely affect women because of their anatomy," Dr. Crowe said. "But these women's GI health problems don't get much health press and women aren't necessarily the scientists and the physicians driving those areas of research. And so, women's health issues are somewhat underrepresented in gastroenterology."

Clinical Symposia and State-of-the-Art Lectures
For clinicians, depending on what their clinical interests are — whether pediatrics, inflammatory bowel disease, pancreas, liver, colon cancer or diarrhea — there will be new information presented in many different forums and venues.

Highlights from among AGA's Clinical Symposia include:
• Eosinophilic Esophagitis: New Data on an Emerging Clinical Entity
• Treatment of IBD: Now and the Future
• Clinical Challenges in UGI Disorders
• Therapeutic Interventions in Pancreaticobiliary Diseases
• Ulcerative Colitis: Have We Improved the Natural History?
• New and Emerging Approaches to the Management of Irritable Bowel Syndrome
• Multimodality Approach to Detection and Intervention in Barrett's Esophagus
• Optimal Therapies for H. pylori in a Changing Environment: A Global Perspective
• Pediatric Inflammatory Bowel Disease: Clinical and Translational Research
• Advances in NOTES
• New Innovations in Colorectal Cancer Screening
• Imaging Advances for GI Disease
• Endoscopic Optical Biopsy Techniques
• Colorectal Cancer Screening — Are We Endoscopists, Radiologists or Bystanders?

During state-of-the art lectures, eminent speakers will address topics ranging from basic mechanisms regulating calcium signaling and homeostasis to genomic analysis in pancreatic cancer to receptor tyrosine kinases: signaling, systems biology and targeted therapeutics in cancers.

"We do have a great number of state-of-the-art conferences this year. They're all basic science-related and they all represent excellent scientists," Dr. Crowe said.

Speakers include:
• Ole H. Petersen, CBE, MD, FRCP, FMedSci, FRS, "Basic Mechanisms Regulating Calcium Signaling and Homeostasis."
• W. James Nelson, PhD, "Epithelial Adhesion, Polarity and Repair."
• Nicholas Papadopoulos, MD, "Genomic Analysis of Pancreatic Cancer."
• Yosef Yarden, MD, "Receptor Tyrosine Kinases: Signaling, Systems Biology and Targeted Therapeutics in Cancers."
• Didier Y. R. Stainier, PhD, "Endodermal Organ Development in Zebrafish."

Focused Clinical Updates, Focused Research Roundtables
Early risers will be treated to the latest in clinical research abstracts and basic science abstracts over breakfast from 6:45 a.m. to 8 a.m. May 31 and June 1.

This year's Focused Clinical Updates include "H. pylori Diagnosis and Treatment in 2009," presented by Steven Moss, MD, and "Emerging Therapies in IBD," presented by Subrata Ghosh, MD, PhD, on May 31; and "Peptic Ulcer Disease," presented by Mitchell Schubert, MD, AGAF, and "Pediatric Issues in UGI Diseases," by Nicola Jones, PhD, on June 1.

Focused Research Roundtables include "Clinical and Molecular Determinants in Barrett's," presented by Yvonne Romero, MD, and "Highlights of Mucosal Immunology," presented by Maria T. Abreu, MD, on May 31 and "Molecular Biology of GI Cancer," presented by John P. Lynch, MD, and "Updates in Pancreatitis Research: TRPV1 and Beyond," presented by Rodger A. Liddle, MD, on June 1.

Curbside Consultant Sessions
To facilitate more interaction between attendees and presenters, the AGA Institute Education and Training Committee also changed the format of two of the Meet the Professor Sessions to Curbside Consults Sessions, one held Monday on difficult ERCP cases and the other, held Tuesday, on difficult IBD cases.

"There will be no prepared talks from these two speakers. Instead, the audience will ask the professors questions on anything they wish on the general topic of difficult cases in IBD or ERCP," Dr. Crowe said. "It's essentially a question-and-answer session for the audience who is meeting with the experts and getting their opinion on difficult cases and related issues."

Morton I. Grossman Lecture
Cynthia Kenyon, PhD, will deliver this year's Morton I. Grossman Distinguished Lectureship, From Worms to Mammals: Genes and Cells that Regulate the Aging Process.

Kenyon is director of The Kenyon Lab, department of biophysics and biochemistry, University of California, San Francisco. The Kenyon Lab studies genes and cells that control aging in the roundworm C. elegans. The lectureship honors the contributions of Morton I. Grossman, MD, who is considered the father of modern gastrointestinal endocrine physiology.

Overarching Basic Science Symposium
This year's AGA Overarching Basic Science Symposium, June 3, also promises to be a crowd-pleaser.

Aaron Ciechanover, MD, recipient of the 2004 Nobel Prize in Chemistry, will discuss the implications of his research findings in The Ubiquitin-Proteasome System in Human Diseases and Drug Targeting.

Registration for ticketed sessions can be completed when you register for DDW or added to an existing registration at any time online at www.ddw.org.

Nobel laureate Aaron Ciechanover, MD, will be the featured speaker of the June 3 AGA Institute Overarching Basic Science Symposium, titled, The Ubiquitin-Proteasome System in Human Diseases and Drug Targeting.

Dr. Ciechanover, a professor at the Technion - Israel Institute of Technology, Haifa, was awarded the 2004 Nobel Prize in chemistry for the discovery of ubiquitin-mediated protein degradation. He shares the award with Avram Hershko, MD, also with Technion - Israel Institute of Technology, and Irwin Rose, MD, University of California, Irvine.

"Dr. Ciechanover is a seminal investigator in that the discoveries that he made in his laboratory had almost immediate clinical and translational benefit," said session co-moderator Richard M. Peek Jr., MD. "He identified a modification system in the cell that targets multiple proteins for degradation. One of the components of this system is the proteasome, and drugs have now been developed that specifically block or target this component and thus can modify a degradation system within the cell."

Many new targets or proteins have been discovered that are modified by Dr. Ciechanover's system, Dr. Peek said, and he anticipates even more will be discovered in the future.

"Many new tumor suppressor genes or oncogenes are likely to be regulated by this modification system. If one can block, or in some cases augment, this modification system, then the ability to manipulate the level of cancer-related proteins will be feasible," he said.

Dr. Ciechanover's discovery has the potential to profoundly alter disease outcomes, said co-moderator John M. Carethers, MD, vice chair of the Gastrointestinal Oncology Section of the AGA Institute Council.

"With drug targeting, clinicians can hopefully try to slow down some of these unusual diseases that have the ubiquitin proteasome system abnormally activated so that a person with a particular disease wouldn't die as fast. For example, we could slow the process down from say, two years to 20 years," he said. "I think there are a wide variety of medical professionals — from basic scientists to translation researchers to clinical gastroenterologists — trying to understand the process, but they have to understand the ubiquitin science before they can do so."

The AGA Institute Council, Dr. Carethers said, strives to develop programs for DDW® that reflect a wide variety of digestive diseases, as well as select lecturers who are considered renowned experts in their fields.

"From what I understand, Dr. Ciechanover is a fantastic speaker. Attendees are in for a real treat," he said.

ASGE?s scheduled offerings for DDW® 2009 will provide attendees with numerous opportunities to enrich their knowledge base and skill set, and celebrate the accomplishments of their colleagues.

Highlights include the 2009 Crystal Awards, a groundbreaking postgraduate course and a number of special sessions and events including: the ASGE Masters Series Course: Enteroscopy in the 21st Century; Breakfast with Champions; Hands-On Course: Advanced Endoscopy Techniques; Hands-On Workshops; Introduction to Capsule Endoscopy; Poster Grand Rounds and the Fellows Luncheon.

?Not only is there something for everyone, there?s something at any time for everyone,? said M. Brian Fennerty, MD, FASGE, ASGE secretary and program chair, and professor of medicine at Oregon Health and Science University, Portland. ?Each time block has either an abstract-driven session or one or more clinical symposia that each attendee can choose from.?

While aspects of the ASGE program are specific and geared toward more in-depth knowledge, the majority is focused on practical information.

?The majority of programming is about the nuts and bolts ? the common things and which things will become more common,? Dr. Fennerty said. ?It?s based in current practice, but it?s meant to let attendees optimize their practice. It?s meant for the general gastroendoscopist who uses endoscopy in his or her everyday practice.?

Dr. Fennerty?s hope is that attendees who take advantage of the program?s offerings will leave DDW prepared for the future of their practice and the work they love in general.

?It is really meant to either allow the attendee to see the state of the art or the future of endoscopic management of gastrointestinal disorders, or an opportunity to serve as a refresher course for them,? he said. ?It should allow one to understand what the state of the art is in May 2009 and what likely is just around the corner.?

Crystal Awards
ASGE will honor important contributions to the field of endoscopy during the fifth annual ASGE Crystal Awards on Sunday, May 31. Hosted by ASGE and the ASGE Foundation, this year?s event will begin with a reception at 6:30 p.m. at Chicago?s Navy Pier. The dinner, awards presentation and dancing will begin at 7:30 p.m.

The Crystal Awards symbolize the finest in leadership, research and scientific pursuit, recognizing the year?s award and grant recipients who have strengthened the specialty and the society. More than 20 awards ? including the prestigious Rudolf V. Schindler Award ? will be presented during the event. Newly designated ASGE Fellows also will be recognized.

Reservations for the event are $250 and can be purchased at www.asge.org or by calling Ashley Gill, ASGE Foundation coordinator, at (866) 353-2743 or foundation@asge.org.

Proceeds from the event will benefit the foundation in support of GI endoscopy-related research, physician education and training, and public outreach initiatives.

To make a tax-deductible contribution to the ASGE Foundation, stop by the ASGE Store at DDW, visit www.asge.org, or call (630) 573-0600 or (800) 353-ASGE.

Postgraduate Course
Join leaders in gastrointestinal endoscopy and your GI colleagues from around the world to discuss the latest technological advances in the field at ASGE?s 2009 Postgraduate Course, Endoscopy at Home and Around the World: New Developments and Innovations for Your Practice, June 3 and 4.

This course will feature live cases transmitted in real time from New York's Lenox Hill Hospital, including a moderated discussion of these cases with an expert panel. Internationally renowned faculty also will discuss topics relevant to your endoscopy practice and present evidence-based, state-of-the-art lectures on the endoscopic management of a variety of gastrointestinal diseases. Twelve specialty breakout sessions will cover some of GI?s most challenging procedures.

?We have gathered what we believe is an extremely talented, cutting-edge and entertaining faculty,? said Ian M. Gralnek, MD, MSHS, FASGE, course co-director. ?We have faculty from the U.S., Canada, Europe, the Middle East and the Far East. These are all internationally renowned faculty, leaders in the field of gastrointestinal endoscopy.?

The course is geared toward a variety of people, including practicing gastroenterologists, gastrointestinal surgeons, physicians performing gastrointestinal endoscopy, gastroenterology fellows and trainees, medical and surgical residents, physician assistants, gastrointestinal endoscopy nurses and technicians, as well as those in the biomedical-technology industry.

As a result of attending this course, registrants will be able to:
• Discuss endoscopic methods and principles from a national and international perspective, highlighting different diagnostic and management approaches to gastrointestinal disorders.
• Describe potential complications of gastrointestinal endoscopy and their management.
• Discuss current and emerging techniques and technologies in gastrointestinal endoscopy, and how to use these to enhance care of patients with gastrointestinal disease.
• Identify the role of gastrointestinal endoscopy in the identification and management of patients with malignancies and other GI disorders.

David A. Greenwald, MD, FASGE, from Montefiore Medical Center in Bronx, NY, and Klaus Mergener, MD, PhD, CPE, FASGE, from Digestive Health Specialists in Tacoma, WA, are co-directors for the course.

To register for the 2009 ASGE Postgraduate Course, use the DDW registration form or register online at www.ddw.org.

This course is supported, in part, by educational grants from AstraZeneca Pharmaceuticals LP, Boston Scientific, Olympus America, PENTAX Medical Company and US Endoscopy.

ASGE will offer a two-day Masters Series Course: Enteroscopy in the 21st Century to teach gastroenterologists how to navigate enteroscopes with overtube devices deep into the small bowel. Since space is limited to 60 participants, online preregistration is encouraged for the course, which will be held May 29 and 30.

?This course is designed to train gastroenterologists in the latest technologies of deep small bowel endoscopy ? double balloon, single balloon and spiral,? said course moderator Carol E. Semrad, MD. ?I use the term ?deep small bowel endoscopy? to distinguish it from standard push enteroscopy that usually only reaches proximal jejunum.?

The course will focus on types of equipment and tools available for performing enteroscopy, set-up of units to perform the procedure and detailed methodology on its appropriate use in small bowel diseases, said Dr. Semrad, associate professor of medicine, GI section, University of Chicago. Enteroscopy experts will deliver lectures accompanied by edited videos of actual cases and supervise hands-on training stations.

?Deep small bowel endoscopy closes the gap between upper and lower GI procedures,? Dr. Semrad said. ?The gap started to close with video capsule endoscopy, and now these new enteroscopes allow visualization, tissue sampling and therapeutic procedures. We have much to learn about small bowel diseases that we were never able to see before. It?s going to change much of what we know about small bowel lesions and their management ? in particular bleeding lesions, small bowel tumors and ulcerating disease such as small bowel Crohn?s disease.?

In the past, she noted, small bowel tumors went undetected for long periods of time.

This ASGE Masters Series Course is open to all physicians, but targets experienced gastroenterologists; registration is limited. This technology is so new that few are trained in the procedure, Dr. Semrad said, and this course offers a unique opportunity for physicians who may not be exposed to these techniques elsewhere. The course also presents a networking opportunity for participants to meet faculty experts who may become sources of information and hands-on training.

Dr. Semrad called the course ?a foundational step.? Next training steps for participants include observing cases performed in gastrointestinal units and eventually performing procedures on their own.

?There is a need for gastroenterologists to learn this technology,? Dr. Semrad said. ?Not all GI fellows are trained uniformly in procedures, and new technologies come onto the market once we are out in practice. An effective way to update gastroenterologists and train them in new technologies is the two-day Masters Series Courses that are intensely focused on all aspects of a new technology.?

ASGE Master Series Courses are not meant to replace other GI training, Dr. Semrad said. Instead, the courses are designed as a foundation to provide didactic and hands-on training in the procedure. ?These two-day courses cover new or updated endoscopic technologies and tools so we can maintain our knowledge base and skills.?

This course is supported, in part, by an educational grant from Olympus America and Spirus Medical, Inc.

The SSAT program at DDW® has grown significantly in recent years, and that trend will continue in 2009 as the society offers four video sessions, two subject-focused plenary sessions, two debate sessions and three new case-based presentations: SSAT Clinical Ward Rounds.

This combination of new and expanded sessions will supplement many of SSAT?s popular established presentations, such as the Postgraduate Course, Presidential Plenary sessions, State-of-the-Art Conference, Quick Shot sessions, joint symposia with sister societies and lectures.

?The mantra I try to live by is, ?Make sure all the areas of the membership have something of interest to attend at all times,?? said Mark P. Callery, MD, SSAT program chair. ?There is always something happening for the esophageal, pancreas, liver and colorectal people to enjoy.?

For the third year in a row, more than 400 abstracts have been submitted for the SSAT program, and so the society is taking advantage of the space available at Chicago?s McCormick Place to develop more forums for those abstracts.

?This year, we have had 57 high-quality videos submitted. We have grown from a single video session a few years ago to three sessions last year, and for this meeting we are going to have at least four video sessions,? he said. ?They will all have the principal author presenting a 10-minute video, with five to six minutes for discussion.?

Seven plenary sessions are again on the schedule, but two will focus on specific areas as introduced last year ? basic science and translational science.

?The Basic Science Plenary will have the best of the best basic plenary abstracts presented,? Dr. Callery said. ?For the Translational Science Plenary, the program committee has worked to identify the most competitive abstracts that take basic science concepts and really promulgate them within the context of clinical work.?

Another popular presentation that has been expanded is Controversies in GI Surgery, which in the past offered three separate debates during one session. This year, four debate topics will be presented in two sessions.

?We have had a lot of positive feedback on the debates,? Dr. Callery said. ?They were done as a single session with three debates, and we had home runs in debate No. 1 and debate No. 2. But the people in debate No. 3 were saying, ?I wish those people hadn?t taken so much of the time.? To correct that and grow the program, we are now expanding from one to two sessions.?

New to the program this year will be three interactive, case-based, one-hour SSAT Clinical Ward Rounds, which will focus on the midgut, hindgut and foregut.

?Each session will have a moderator and four to five panelists who are specialists in the field who will present clinical cases,? Dr. Callery said. ?These will be intimate sessions with 40 to 60 attendees and a lot of audience participation. I think this will be a fun, new highlight of practical learning for the people who come. The panelists will bring in their own cases and others will discuss them. This will give doctors in the audience a chance to engage and feel like part of the team.?

Other traditional elements of the SSAT program that will be presented include:
• The SSAT Postgraduate Course, Acute Care Gastrointestinal Surgery: Thinking on Your Feet ? A Case-Based Course, which will be a full day of case presentations on May 31.
• The Opening Session, which will include the Presidential Address and Doris and John L. Cameron Guest Oration and the Maja and Frank G. Moody State-of-the-Art Lecture.
• Three Quick Shot sessions, which are four-minute presentations of abstracts followed by two minutes for questions from the audience.
• Joint symposia with the American Hepato-Pancreato-Biliary Association (AHPBA), the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), the American Society of Colon and Rectal Surgeons (ASCRS) and the International Society for Digestive Surgery (ISDS).
• The Public Policy Committee Panel, Genomics and Cancer Care: What Every Clinician Should Know.
• The Education Committee Panel, Advancing Endoscopy in GI Surgery.

Advances in the use of genetic information for the treatment of colon cancer and related ethical questions will be discussed during the SSAT Public Policy Panel, Genomics and Cancer Care: What Every Clinician Should Know.

?We are beginning to utilize different aspects of molecular genetics in the clinical work that we do both diagnostically and therapeutically,? said Thomas Howard, MD, session moderator. ?We?ll focus on patients with hereditary colon cancer syndromes, which is probably the most developed in terms of using genetic testing to identify patients and families at risk for specific investigations and treatment of all gastrointestinal malignancies,? said Dr. Howard, professor in the department of surgery at Indiana University School of Medicine, Indianapolis.

The session, which will be presented June 2, will feature three speakers who will discuss the use of genetic testing to identify patients with germline mutations in the clinic, the use of genetic information to guide the choice of adjuvant chemotherapy, and post-treatment surveillance in patients with colon cancer. Speakers also will discuss whether current health-care policies are adequate in ensuring third-party reimbursement for genetic testing and confidentiality for patients with hereditary colorectal cancer syndromes and their families.

C. Richard Boland, MD, chief of the division of gastroenterology at Baylor University Medical Center, Dallas, TX, will lead off the symposium by outlining who should be sent for genetic testing in hereditary colorectal cancer syndromes.

?Dr. Boland will talk about how clinicians should identify patients in their clinics, deciding which patients to test and for which syndrome, and discussing some of the pros and cons of obtaining those tests,? Dr. Howard said. ?He has been a leader in the field of colorectal neoplasia and the identification of molecular mechanisms related to genomic alterations in patients with hereditary colorectal cancer syndromes, particularly patients with hereditary nonpolyposis colorectal cancer.?

Accurately identifying patients at risk for colon cancer could lead to improved screening of those at risk, better surveillance of patients with the disease, and earlier diagnosis and treatment of malignancies, he said.

?In patients diagnosed with early stage colon cancer following tumor resection, adjuvant chemotherapy is given to all patients to prevent tumor recurrence, but only about one out of three patients derive any benefit from this therapy,? Dr. Howard said. ?Genomic signatures are beginning to influence how one treats a specific cancer and the whole concept of ?personalized? therapy is based on identifying each cancer patient?s unique tumor biology.?

A second speaker, Kenneth C. Micetich, MD, professor of medicine, hematology/oncology at Loyola University Stritch School of Medicine, Chicago, IL, will discuss the current adjuvant chemotherapy treatment guidelines and how genetic testing now influences treatment in patients with colorectal cancer and hereditary colon cancer syndromes.

?Dr. Micetich will talk about our current use of genetic testing in individual resected tumor specimens and how the identification of abnormalities such as microsatellite instability or epidermal growth factor receptors influence the types of drugs we use for adjuvant chemotherapy as well as whether these additional studies are currently covered by third-party payors,? Dr. Howard said.

?One of the biggest concerns in investigating germline genetic mutations is how this knowledge influences not only the care of patients, but their immediate and extended family, as well as future generations,? he said. ?In my view, this interconnectedness lies at the heart of the ethical issues one faces when deciding to proceed with genetic testing for germline mutations.?

The final speaker, Kimberly A. Quaid, PhD, professor of medical and molecular genetics, at the Indiana University School of Medicine, Indianapolis, will discuss whether current health-care policies are adequate to provide protection for patients and their families.

?One of the topics I hope she will address is the Genetic Information Nondiscrimination Act of 2008,? Dr. Howard said of Quaid, who is a medical ethicist with a research interest in ethical considerations surrounding genetic testing.

?Some patients may hesitate to undergo important genetic testing because of how this information might impact their future employment and ability to get health insurance. This recent law has been crafted in an effort to ensure genetic information remains confidential and cannot be used against patients or their families. I would love to hear her perspective on how this new legislation is impacting the use of genetic testing in our clinics.?