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Alcoholic liver diseases and associated damage of other digestive organs in chronic alcoholics
S149 A L C O H O L LIVER D I S E A S E
ESSENTIAL FATTYACIDDETICII~ICYIN ALCOHOLIC LIVER DISEASE
V. l~o, Institute of Biochemistry, 230009 Gredno, Belarus Chronic alcohol inLoxicatien is accompanied by essential fatty acid (~A) deficiency which, in turn, leads to a decrease of prostaglandin (Pg)level in the liver. The decrease of the content of P ~ having hepatoprotective properties promotes a formation of
acetaldehyde-protein addects in the liver including alkylatien of P~ receptors of liver plasma mombrane~ (LPN). The c~-dependent signal transduction from I ~ receptors to protei, kinase A disturbs in this ray in ETA and P(~ deficiency caused by ethanol. Disturbances in l i v e r enzyme phospbory]atien-dephosphorylaticn is one of the liver damagini[ factors in chronic alcohol
intoxication. The second mechanism of alcoholic liver injury related to EFA and P~ deficiency is an increase cf free o~gen radicals formation hy the microsomal cytechromo P-450 system. Chronic alcohol intoxication eives rise to cytechromo P-450 content, 14ADPH-induced chemol~iniscence of microsomos and superoxide dismutase activity. I~E and polyensaturated phosphatidylcboline {PPC) normalizes all the above parameters in the liver. P ~ and PPC also correct the structural changes in microsomal membrane due to ethanol: rigidity. hydrophobicity, lipid bilayer order and lipid-protein interactions. Thus, ve have shown at least two mechanisms of alcoholic liver injury which ,are dependenton the essential fatty acid deficiency.
FATTY LIVER(FL):CLINICAL,BIOCHEMICAL,IMAGING AND HISTOLOGICAL STUDY DeBt.of Gastrenterology I and Pathological Laborato ~ ryZ,NIMITS Athens Medical Dept. of 7th Hospital of IKA 3 Athens P.Gabriel I'3 P.Tsiodra3,D.Triantafyllou3,G.'I~niakos 2 D.LyraZ,N.Kalantzisl,N.Papanicolaou3 Fatty liver(F.L) is due to many causes. The a~m of this study was the analysis of the aetiology and the comparison of biochemical,histological changes , together with UIS and CAT imaging. We have studied 76 pts with F.L(all proven with biopsy)47men,29women (m.age 50). F.L was asymptomatic in 70 pts(92%) and etiologically was attributed to chronic alcoholism(3Opts),diabetes mellitus (22),obesity(5),drugs (5),hyperlipemia IV(2),no cause(ll). Main disorders of hepatic biology were:elevation of V -GT(35)~abnormalSer.transaminases(15)~levation of ~-globulin(il)and alkaline phosphatase(7). Liver biopsies showed:diffuse steatosis 52cases(69%) steatohepatitis 10(13%),steatosis with fibrosis q(5~ steatosis with cirrhosis 10(13%). Imaging showed high liver echoes in the UIS in 98% of pts and low density in the CAT in 82%. We concluded that usually F.L is asymptomatic with little change~ in the liver biology. The finding of v-globulin elevation can be an early predictor of cirrhosis Imaging with UIS and CAT has high diagnostic accuracy(~gq%) and the severity of histological changes correlates well with the aetiology of Fatty Liver.
THE INFLUENCE OF ALCOHOL ON HBV MARKERS AND THE HISTOPATHOLOGICAL PICTURE OF CHRONIC HEPATITIS B A. Gabriel*, W. 7_,ajecki*, M. Beniowaki**, Z. Szczuxek* I Dsparlynent of Pathology * and Ingdtu~ of L-Lfectious Diseases**, SilesianMedical Academy, Zabrze, Poland
The examination included 20 patients who were diagnosed as suffering from chronic hep~tifi~ with HBV infection aetiology, and confessed to long lasting alcohol abuse. All patients were subjected to histopathological examination of liver biopsy and serological HBV markers were determined. Continual presence o f HBsAg and HBeAg was found in 80°6 of the patients. Almost aIl of them displayed aggressive forms of infection with III° inflammatory activity dominming. The phenomenon of antigen "e" seroconversion and antigen '%" elimination from the serum was found in three cases only Introductory analysis of patients with chronic hepatitis of HBV aedology, .who were addicted to alcohoLevealed more advanced and active forms of h'Lflammafion as well as sporadic elimination of "'e" and "s" antigens and provided evidence that the replication stage of the disease lasts longer.
ALCOHOLIC LIVER DISEASES AND ASSOCIATED DAMAGE OF OTHER DIGESTIVE ORGANS IN CHRONIC ALCOHOLICS A.Irnins. D.Soei~ien& T.Semuchinien~. RAmmevidiend, A..Tamogigma~ Vilnius University, Lithuania. The goal of this work was to perform a complex gastrocnterological examination of the patients with chronic alcoholic abuse in order to reveal the injury of the liver other digestive organs. The study involved 105 inpatients (89 males and 16 females): 7 patients with chronic alcoholism (CA) Stage I, 92-CA stage II, 6-CA stage HI. Clinical investigations were performed, including liver and gastric mucosa biopsy. The data obtained shoved liver injury: alcoholic hepatosis in 24 (22.8%), chronic alcoholic hepatitis (CAH) with mild activity - ill 60 (57.1%), CAH with severe activity - in 8 (7.6%), alcoholic liver cirrhosis - in 7 (6.7%). In 77.75% morphological and functional lesions o[ esophagogastroudodensl zone wexe found: antrum erosive gastritis, duodenitis, atrophic gastritis and etc.. Alcoholic pancreatitis was diagnosed in 25.7% of patients. Associate damage of two digestive organs (liver and stomach) was found in 36.2% of cases, damage of 3 organs (liver, stomach, pancreas) in 32.4% and of four organs (liver, stomach, pancreas colon and/or gallbladder) in 17.1%. The Eesults testify the complex and syste]nic action of alcohol on various organs of digestive system and high frequency of combined lesions. Tlwse results ate of importance as concerns the improvement of diagnosis and treatment of patients suffering from a[coholism.
ESSENTIAL FATTYACIDDETICII~ICYIN ALCOHOLIC LIVER DISEASE
V. l~o, Institute of Biochemistry, 230009 Gredno, Belarus Chronic alcohol inLoxicatien is accompanied by essential fatty acid (~A) deficiency which, in turn, leads to a decrease of prostaglandin (Pg)level in the liver. The decrease of the content of P ~ having hepatoprotective properties promotes a formation of
acetaldehyde-protein addects in the liver including alkylatien of P~ receptors of liver plasma mombrane~ (LPN). The c~-dependent signal transduction from I ~ receptors to protei, kinase A disturbs in this ray in ETA and P(~ deficiency caused by ethanol. Disturbances in l i v e r enzyme phospbory]atien-dephosphorylaticn is one of the liver damagini[ factors in chronic alcohol
intoxication. The second mechanism of alcoholic liver injury related to EFA and P~ deficiency is an increase cf free o~gen radicals formation hy the microsomal cytechromo P-450 system. Chronic alcohol intoxication eives rise to cytechromo P-450 content, 14ADPH-induced chemol~iniscence of microsomos and superoxide dismutase activity. I~E and polyensaturated phosphatidylcboline {PPC) normalizes all the above parameters in the liver. P ~ and PPC also correct the structural changes in microsomal membrane due to ethanol: rigidity. hydrophobicity, lipid bilayer order and lipid-protein interactions. Thus, ve have shown at least two mechanisms of alcoholic liver injury which ,are dependenton the essential fatty acid deficiency.
FATTY LIVER(FL):CLINICAL,BIOCHEMICAL,IMAGING AND HISTOLOGICAL STUDY DeBt.of Gastrenterology I and Pathological Laborato ~ ryZ,NIMITS Athens Medical Dept. of 7th Hospital of IKA 3 Athens P.Gabriel I'3 P.Tsiodra3,D.Triantafyllou3,G.'I~niakos 2 D.LyraZ,N.Kalantzisl,N.Papanicolaou3 Fatty liver(F.L) is due to many causes. The a~m of this study was the analysis of the aetiology and the comparison of biochemical,histological changes , together with UIS and CAT imaging. We have studied 76 pts with F.L(all proven with biopsy)47men,29women (m.age 50). F.L was asymptomatic in 70 pts(92%) and etiologically was attributed to chronic alcoholism(3Opts),diabetes mellitus (22),obesity(5),drugs (5),hyperlipemia IV(2),no cause(ll). Main disorders of hepatic biology were:elevation of V -GT(35)~abnormalSer.transaminases(15)~levation of ~-globulin(il)and alkaline phosphatase(7). Liver biopsies showed:diffuse steatosis 52cases(69%) steatohepatitis 10(13%),steatosis with fibrosis q(5~ steatosis with cirrhosis 10(13%). Imaging showed high liver echoes in the UIS in 98% of pts and low density in the CAT in 82%. We concluded that usually F.L is asymptomatic with little change~ in the liver biology. The finding of v-globulin elevation can be an early predictor of cirrhosis Imaging with UIS and CAT has high diagnostic accuracy(~gq%) and the severity of histological changes correlates well with the aetiology of Fatty Liver.
THE INFLUENCE OF ALCOHOL ON HBV MARKERS AND THE HISTOPATHOLOGICAL PICTURE OF CHRONIC HEPATITIS B A. Gabriel*, W. 7_,ajecki*, M. Beniowaki**, Z. Szczuxek* I Dsparlynent of Pathology * and Ingdtu~ of L-Lfectious Diseases**, SilesianMedical Academy, Zabrze, Poland
The examination included 20 patients who were diagnosed as suffering from chronic hep~tifi~ with HBV infection aetiology, and confessed to long lasting alcohol abuse. All patients were subjected to histopathological examination of liver biopsy and serological HBV markers were determined. Continual presence o f HBsAg and HBeAg was found in 80°6 of the patients. Almost aIl of them displayed aggressive forms of infection with III° inflammatory activity dominming. The phenomenon of antigen "e" seroconversion and antigen '%" elimination from the serum was found in three cases only Introductory analysis of patients with chronic hepatitis of HBV aedology, .who were addicted to alcohoLevealed more advanced and active forms of h'Lflammafion as well as sporadic elimination of "'e" and "s" antigens and provided evidence that the replication stage of the disease lasts longer.
ALCOHOLIC LIVER DISEASES AND ASSOCIATED DAMAGE OF OTHER DIGESTIVE ORGANS IN CHRONIC ALCOHOLICS A.Irnins. D.Soei~ien& T.Semuchinien~. RAmmevidiend, A..Tamogigma~ Vilnius University, Lithuania. The goal of this work was to perform a complex gastrocnterological examination of the patients with chronic alcoholic abuse in order to reveal the injury of the liver other digestive organs. The study involved 105 inpatients (89 males and 16 females): 7 patients with chronic alcoholism (CA) Stage I, 92-CA stage II, 6-CA stage HI. Clinical investigations were performed, including liver and gastric mucosa biopsy. The data obtained shoved liver injury: alcoholic hepatosis in 24 (22.8%), chronic alcoholic hepatitis (CAH) with mild activity - ill 60 (57.1%), CAH with severe activity - in 8 (7.6%), alcoholic liver cirrhosis - in 7 (6.7%). In 77.75% morphological and functional lesions o[ esophagogastroudodensl zone wexe found: antrum erosive gastritis, duodenitis, atrophic gastritis and etc.. Alcoholic pancreatitis was diagnosed in 25.7% of patients. Associate damage of two digestive organs (liver and stomach) was found in 36.2% of cases, damage of 3 organs (liver, stomach, pancreas) in 32.4% and of four organs (liver, stomach, pancreas colon and/or gallbladder) in 17.1%. The Eesults testify the complex and syste]nic action of alcohol on various organs of digestive system and high frequency of combined lesions. Tlwse results ate of importance as concerns the improvement of diagnosis and treatment of patients suffering from a[coholism.