OBJECTIVETo study the clinical characteristics of patients with alcoholic liver disease (ALD).

METHODSThe records of the 302 Hospital of People's Liberation Army (Beijing, China) were searched to identify patients diagnosed with liver disease for retrospective analysis of ALD. Measurement data was summarized as mean +/- standard deviation and intergroup comparisons were made using ANOVA; count data was assessed using the chi-square test.

RESULTSAmong the total 4132 ALD cases, 97.68% were male and 2.32% were female; ages ranged from 18 to 95 years-old,with the average age being 48.11+/-10.58 years and the range of 40 to 60 years-old being the most frequently represented.Considering all patients with liver disease from 2003 to 2012,ALD cases increased over time (from 2.00% in 2003 to 5.05% in 2012). The overall ALD cases were represented by alcoholic cirrhosis (70.35%), alcoholic hepatitis (19.26%), alcoholic fatty liver (6.29%), and alcoholic liver failure (4.09%). Among the ALD patients between 40 and 60 years of age, 73.81% had cirrhosis,compared to 50.42% of ALD patients less than 40 years-old (P less than 0.001). Comparison of ALD cases in 5-year increments showed increasing trends in rates of alcoholic cirrhosis and alcoholic hepatic failure;moreover, there was an increasing annual trend in the percentage of alcoholic liver failure cases among the total cases of liver failure in our hospital.

CONCLUSIONFrom 2003 to 2012,our hospital admissions increased for patients with alcoholic liver disease, and the patients were primarily in the age range of 40-60 years-old. In general, incidences of alcoholic liver failure and cirrhosis increased in recent years, and cirrhosis has been common among the elderly patients with ALD.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Beijing ; Fatty Liver, Alcoholic ; epidemiology ; Female ; Hepatitis, Alcoholic ; epidemiology ; Humans ; Incidence ; Liver Cirrhosis ; epidemiology ; Liver Diseases, Alcoholic ; epidemiology ; Liver Failure ; epidemiology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Hepatocellular carcinoma (HCC) have relatively well known causative factors such as chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, Non-alcoholic fatty liver disease (NAFLD), liver cirrhosis and so on. Recently, interesting reports that HCC in the absence of cirrhosis or other chronic liver disease and HCC associated with NAFLD and metabolic syndrome are increasing in USA. So far, there is no report about these issues in Korea. We present a 65 year-old obesity male who had no preceding chronic liver disease history. He was diagnosed as primary HCC and the mass was removed completely. However, HCC recurred shortly after operation. Multiple recurred HCC were treated with transcatheter arterial chemoembolization.
Carcinoma, Hepatocellular* ; Chemoembolization, Therapeutic ; Fatty Liver ; Fibrosis ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Humans ; Korea ; Liver Cirrhosis ; Liver Diseases* ; Liver Diseases, Alcoholic ; Liver* ; Male ; Obesity ; Recurrence

With recent developments, biologic therapies has shown superior efficacy for rheumatic diseases compared with preexisting pharmacologic therapies, which are associated with high costs, non-response in certain patient groups, and severe adverse effects such as infections limiting their wide-spread use and revealing a need for the development of novel treatments. Since discovering the role of bile acid receptors in regulating inflammation, clinical trials evaluating the use of bile acid receptor agonists as a means to potentially treat various inflammatory disorders, such as alcoholic hepatitis, non-alcoholic steatohepatitis, primary biliary cirrhosis, primary sclerosing cholangitis have been ongoing. This review summarizes the results of studies on the anti-inflammatory effects and mechanisms of bile acid receptors and the results of previous to date looking at the use of bile acid receptor agonists in animal models of inflammatory disorders and clinical trials. Furthermore, we present the potentials of the bile acid receptor agonists in the treatment of inflammatory rheumatic diseases, including rheumatoid arthritis.
Arthritis, Rheumatoid ; Bile* ; Biological Therapy ; Cholangitis, Sclerosing ; Fatty Liver ; Hepatitis, Alcoholic ; Humans ; Inflammation ; Liver Cirrhosis, Biliary ; Models, Animal ; Rheumatic Diseases

Since liver function is changed by chronic liver diseases, chronic liver disease can lead to different hemorheological alterations during the course of the progression. This study aims to compare alterations in whole blood viscosity in patients with chronic liver disease, focusing on the gender effect. Chronic liver diseases were classified into three categories by patient’s history, serologic markers, and radiologic findings: nonalcoholic fatty liver disease (NAFLD) (n = 63), chronic viral hepatitis B and C (n = 50), and liver cirrhosis (LC) (n = 35). Whole blood viscosity was measured by automated scanning capillary tube viscometer, while liver stiffness was measured by transient elastography using FibroScan®. Both systolic and diastolic whole blood viscosities were significantly lower in patients with LC than NAFLD and chronic viral hepatitis (P < 0.001) in male patients, but not in female patients. In correlation analysis, there were inverse relationships between both systolic and diastolic whole blood viscosity and liver stiffness (systolic: r = −0.25, diastolic: r = −0.22). Whole blood viscosity was significantly lower in male patients with LC than NAFLD or chronic viral hepatitis. Our data suggest that whole blood viscosity test can become a useful tool for classifying chronic liver disease and determining the prognosis for different types of chronic liver diseases.
Blood Viscosity ; Capillaries ; Elasticity Imaging Techniques ; Female ; Hemorheology ; Hepatitis ; Hepatitis B ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Male ; Non-alcoholic Fatty Liver Disease ; Prognosis

A study conducted 15-year ago showed that only 13.5% of chronic alcoholics developed alcohol-induced liver damage, which misled some people to believe a lack of relationship between the amount of alcohol and the occurrence of liver disease. However, it is true that a significant correlation exists between per capita consumption and the prevalence of cirrhosis. Alcoholic fatty liver is observed in most of chronic alcoholics even though the severity is not uniform. Abstinence remains the cornerstone of therapy for alcoholic liver disease (ALD). There is also consensus for the use of corticosteroids and pentoxifylline in severe alcoholic hepatitis maintaining good nutritional status to treat comorbidities in all forms of ALD, and liver transplantation in the end-stage ALD patients who can stop drinking for 6 months pre-transplantation period. Several clinical trials targeting tumor necrosis factor (TNF-alpha) and reducing oxidative stress have not been successful at this time. There is still a large field of alcohol research to explore in order to go farther in the area of pathophysiology. We need to understand a role of various cytokines and immune cells in the development of ALD to have more treatment tools to cope with ALD.
Alcohols/metabolism ; Cytochrome P-450 CYP2E1/metabolism ; Fatty Liver, Alcoholic/pathology/therapy ; Humans ; Liver Cirrhosis, Alcoholic/pathology/therapy ; Liver Diseases, Alcoholic/*etiology/pathology/therapy ; Oxidative Stress

BACKGROUND/AIMS: Chronic liver disease is closely associated with lifestyle, and public enlightenment of the lifestyle factors is important in reducing prevalence of chronic liver disease. The KASL (Korean Association for the Study of the Liver) conducted a survey of basic information and epidemiological data regarding chronic liver diseases. METHODS: A survey of chronic liver disease involving a total of 2,794 respondents was conducted. The respondents included patients and their guardians, visitors for health check-ups, and online pollees who completed a questionnaire on the awareness of fatty liver or chronic liver disease. RESULTS: Of the entire cohort, 854 (39.7%) said they have had or still have fatty liver or an elevated transaminase level (>40 IU/L), but only 23.4% of the respondents had visited a hospital. It was found that 35% of healthy subjects and 45% of patients and their guardians misunderstood hepatitis B as the hereditary disesase. Furthermore, 26% of the subjects responded that patients with inactive hepatitis B do not require regular follow-up. While 17.9% answered that it is not too late to test for liver cancer when symptoms arise, 38.8% believed that liver transplant in liver cancer patients has a low success rate and is thus not recommended. CONCLUSIONS: Despite the inundation of information and widespread media advertising, the awareness of chronic liver disease is unsatisfactory among Korean adults. Systematic nationwide studies are needed to obtain data and information regarding the prevalence of chronic liver disease and patterns of use of the health-care system.
Adult ; Chronic Disease ; Cohort Studies ; Fatty Liver/epidemiology ; Female ; *Health Knowledge, Attitudes, Practice ; Hepatitis B, Chronic/epidemiology ; Humans ; Liver Cirrhosis/epidemiology ; Liver Diseases/*epidemiology ; Liver Diseases, Alcoholic/epidemiology ; Liver Neoplasms/epidemiology ; Male ; Middle Aged ; Questionnaires ; Republic of Korea/epidemiology

Obesity is closely associated with hepatocellular carcinoma (HCC) as well as other malignancies. Obesity is an important risk factor for cancer development and overall mortality in HCC. Molecular mechanisms of hepatocarcinogenesis in obesity are adipose tissue remodeling, dysregulation of adipokines, increased reactive oxygen species, insulin resistance or hyperinsulinemia, alteration of gut microbiota, and dysregulation of microRNA. Obesity is the most common cause of non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). NAFLD or NASH leads to HCC as well as liver cirrhosis. Hepatitis C virus regulates lipid homeostasis in liver. Obesity and its’ related factors (metabolic syndrome and diabetes mellitus) are significantly related to the risk of HCC development in chronic hepatitis C. However, it is not clear whether obesity is a risk factor for HCC in chronic hepatitis B. The relationship between obesity and HCC seems to be different according to etiology of background liver disease. Further studies are needed to clarify the effect of obesity on HCC in different etiologies of chronic liver disease.
Adipokines ; Adipose Tissue ; Carcinoma, Hepatocellular* ; Fatty Liver ; Gastrointestinal Microbiome ; Hepacivirus ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Homeostasis ; Hyperinsulinism ; Insulin Resistance ; Liver ; Liver Cirrhosis ; Liver Diseases ; MicroRNAs ; Mortality ; Non-alcoholic Fatty Liver Disease ; Obesity* ; Reactive Oxygen Species ; Risk Factors

The paradigm of chronic liver diseases has been shifting. Although hepatitis B and C viral infections are still the main causes of liver cirrhosis and hepatocellular carcinoma (HCC), the introduction of effective antiviral drugs may control or cure them in the near future. In contrast, the burden of nonalcoholic fatty liver disease (NAFLD) has been increasing for decades, and 25 to 30% of the general population in Korea is estimated to have NAFLD. Over 10% of NAFLD patients may have nonalcoholic steatohepatitis (NASH), a severe form of NAFLD. NASH can progress to cirrhosis and HCC. NASH is currently the second leading cause to be placed on the liver transplantation list in the United States. NAFLD is associated with obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome. The pathophysiology is complex and associated with lipotoxicity, inflammatory cytokines, apoptosis, and insulin resistance. The only proven effective treatment is weight reduction by diet and exercise. However, this may not be effective for advanced fibrosis or cirrhosis. Therefore, effective drugs are urgently needed for treating these conditions. Unfortunately, no drugs have been approved for the treatment of NASH. Many pharmaceutical companies are trying to develop new drugs for the treatment of NASH. Some of them are in phase 2 or 3 clinical trials. Here, pharmacologic therapies in clinical trials, as well as the basic principles of drug therapy, will be reviewed, focusing on pathophysiology.
Antiviral Agents ; Apoptosis ; Carcinoma, Hepatocellular ; Cytokines ; Diet ; Drug Therapy ; Dyslipidemias ; Fibrosis ; Hepatitis B ; Humans ; Insulin Resistance ; Korea ; Liver Cirrhosis ; Liver Diseases ; Liver Transplantation ; Non-alcoholic Fatty Liver Disease ; Obesity ; United States ; Weight Loss

Vitamin K1 is a naturally-occurring vitamin used to treat certain coagulation disorders, and cutaneous adverse reaction to vitamin K1 are infrequently reported. The cutaneous adverse reaction caused by vitamin K1 is called vitamin K1 dermatitis, and includes erythematous plaques, peudoscleroderma, contact dermatitis on epicutaneously exposed skin, and localized urticarial lesions. Vitamin K1 dermatitis can easily be overlooked because of it's low incidence and various morphology, therefore, awareness of past history is important. Most cases of vitamin K1 dermatitis previously reported have been associated with liver diseases, primarily alcoholic liver cirrhosis and viral hepatitis. However vitamin K1 dermatitis can be seen, not only in patients with liver function disturbances, but also in patients without liver disease. We report a case of vitamin K1 dermatitis in a woman who had no liver dysfunction (confirmed by skin test).
Dermatitis* ; Dermatitis, Contact ; Female ; Hepatitis ; Humans ; Incidence ; Liver ; Liver Cirrhosis, Alcoholic ; Liver Diseases ; Skin ; Skin Tests ; Vitamin K 1* ; Vitamins*

Vitamin K1 is a naturally-occurring vitamin used to treat certain coagulation disorders, and cutaneous adverse reaction to vitamin K1 are infrequently reported. The cutaneous adverse reaction caused by vitamin K1 is called vitamin K1 dermatitis, and includes erythematous plaques, peudoscleroderma, contact dermatitis on epicutaneously exposed skin, and localized urticarial lesions. Vitamin K1 dermatitis can easily be overlooked because of it's low incidence and various morphology, therefore, awareness of past history is important. Most cases of vitamin K1 dermatitis previously reported have been associated with liver diseases, primarily alcoholic liver cirrhosis and viral hepatitis. However vitamin K1 dermatitis can be seen, not only in patients with liver function disturbances, but also in patients without liver disease. We report a case of vitamin K1 dermatitis in a woman who had no liver dysfunction (confirmed by skin test).
Dermatitis* ; Dermatitis, Contact ; Female ; Hepatitis ; Humans ; Incidence ; Liver ; Liver Cirrhosis, Alcoholic ; Liver Diseases ; Skin ; Skin Tests ; Vitamin K 1* ; Vitamins*