RE: Digest Number 350

[Guest guest]

Marie...Here is a link on NASH.. <A

HREF= " http://www.geocities.com/HotSprings/Spa/7959/hep/nash.htm " >Untitled</A>

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NONALCOHOLIC STEATOHEPATITIS.

Ludwig J; McGill DB; Lindor KD; Division of Anatomic Pathology, Mayo Clinic,

Rochester, Minnesota 55905, USA. J Gastroenterol Hepatol, 1997 May, 12:5,

398-403

Nonalcoholic steatohepatitis (NASH) is a reasonably well-defined

clinicopathological entity; it has been reported more commonly in women than

in men or children of both sexes and it appears to be most closely associated

with obesity, diabetes mellitus and related abnormalities, such as

hyperlipidaemia and hyperglycaemia. However, the association with female

gender, obesity and diabetes may not be as close as suggested by the

literature and an underlying condition cannot be discerned in all cases. The

natural history of the disease is poorly understood; the associated biopsy

features span a wide spectrum, reaching from uncomplicated, clinically

non-progressive fatty liver (not NASH in a strict sense) to a slowly

progressive fatty liver with inflammation and fibrosis, to steatohepatitis

with submassive hepatic necrosis, which has a subfulminant course and is

often fatal. Non-progressive fatty liver appears to be very common but is of

little clinical importance. The slowly progressive form of the disease

represents NASH as encountered by most clinicians and pathologists. It is a

common liver disease in current practice; patients may present with cirrhosis

and even HCC arising from steatohepatitic cirrhosis. Subfulminant NASH has

become exceedingly rare because many clinicians are now aware of the hazards

of sudden weight loss, particularly in morbidly obese patients. Treatment

options for NASH are still limited. The promotion of gradual weight loss in

obese patients is the most widely recommended therapy but, unfortunately,

this is very difficult to achieve. Avoidance of precipitous weight loss and

careful control of diabetes mellitus are important and undisputed parts of

patient management. Administration of UDCA as a treatment of NASH is still

under study; it may be effective in some patients. The treatment of

established steatohepatitic cirrhosis does not differ substantially from that

of other types of cirrhosis and includes orthotopic liver transplantation.

NONALCOHOLIC STEATOHEPATITIS: MAYO CLINIC EXPERIENCES WITH A HITHERTO UNNAMED

DISEASE.

Ludwig J; Viggiano TR; McGill DB; Oh BJ; Mayo Clin Proc, 1980 Jul, 55:7,

434-8

Nonalcoholic steatohepatitis is a poorly understood and hitherto unnamed

liver disease that histologically mimics alcoholic hepatitis and that also

may progress to cirrhosis. Described here are findings in 20 patients with

nonalcoholic steatohepatitis of unknown cause. The biopsy specimens were

characterized by the presence of striking fatty changes with evidence of

lobular hepatitis, focal necroses with mixed inflammatory infiltrates, and,

in most instances, Mallory bodies; Evidence of fibrosis was found in most

specimens, and cirrhosis was diagnosed in biopsy tissue from three patients.

The disease was more common in women. Most patients were moderately obese,

and many had obesity-associated diseases, such as diabetes mellitus and

cholelithiasis. Presence of hepatomegaly and mild abnormalities of liver

function were common clinical findings. Currently, we know of no effective

therapy.

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HOW IS NONALCOHOLIC STEATOHEPATITIS DIAGNOSED,

Many NASH patients are unaware of their condition because they do not exhibit

any symptoms. In most cases NASH results in a slight increase in liver enzyme

tests, as do other forms of liver disease. In diagnosing NASH, the physician

will first eliminate the other possible causes of chronic liver disease. The

diagnosis must be confirmed by liver biopsy.

Previously, physicians believed that NASH was a benign disorder which did not

progress or was slow in developing. Recent studies and the experience of

physicians indicate that NASH can result in the development of fibrous tissue

in the liver for up to 40% of patients or scarring of the liver (cirrhosis)

in 5-10% of patients. It is not certain why some NASH patients will progress

to this serious form of chronic liver disease while others will not. Studies

report that the progression to fibrosis or cirrhosis for NASH patients is

variable but can occasionally occur in less than 10 years. Many patients with

NASH will show an increase of certain iron proteins (ferritin) in their

blood, but whether this relates to any injury to their liver is unknown.

VS. HISTOLOGIC ABNORMALITIES IN CHC,

If clotting parameters permit or the transjugular biopsy route is available,

patients with chronic HCV infections should be biopsied in order to document

the extent of disease, the likelihood of progression to cirrhosis and in rare

instances, to exclude the presence and/or establish the contribution of

co-existing liver diseases. In addition to the typical features of chronic

hepatitis seen with most viral and non viral causes of chronic liver disease,

there are three useful characteristic, but not diagnostic features of chronic

HCV infections; steatosis (present in 30-70%), lymphoid aggregates (45-80%),

and bile duct damage (20-90%).

AND ABNORMALITIES ASSOCIATED WITH HGV

Clinical implications of GBV-C/HGV infection in patients with

rising-dbl-quote-leftHCV-related' chronic hepatitis - J. Hepatology,

June97,Raffaella Francesconi, Fabrizio Giostra, Giorgio Ballardini, Aldo

Manzin,

It does not worsen the HCV-related disease (ALT levels and histological

activity) and does not significantly interfere with HCV infection, as

explored by the number of hepatocytes positive for HCV antigens. The amount

of steatosis (mean score) was shown to be higher in GBV-C/HGV+ patients. A

virological follow up was performed in 17 interferon-treated GBV-C/HGV+

patients On the whole, GBV-C/HGV seems to be as sensitive to IFN treatment as

HCV, but recurrence after withdrawal is more frequent. In spite of this, ALT

levels often remain normal after treatment withdrawal.

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TWO CASES FROM THE SPECTRUM OF NONALCOHOLIC STEATOHEPATITIS

Abdelmalek M; Ludwig J; Lindor KD; Division of Gastroenterology and Internal

Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. (J

Clin Gastroenterol, 1995 Mar)

Nonalcoholic steatohepatitis is a poorly understood disease that mimics

alcoholic liver disease histologically. Its natural history is not well

defined, although gradual progression to cirrhosis has been described. Most

patients with this condition have been obese, with or without associated

diabetes or hyperlipidemia. No known effective treatment exists for

nonalcoholic steatohepatitis, although weight loss may have a beneficial

effect. We report two cases of nonalcoholic steatohepatitis. One patient with

well-established nonalcoholic steatohepatitis had cirrhosis with a complete

loss of fat on subsequent liver biopsy despite a gain in weight, simulating

cryptogenic cirrhosis. In another patient, the condition improved after use

of ursodeoxycholic acid; this agent may be a potential therapeutic agent for

the treatment of nonalcoholic steatohepatitis. We believe these two cases

represent the spectrum of this condition: on the one end is a progressive

liver disease that in some instances may be a cause of cryptogenic cirrhosis;

at the other end, a potentially treatable liver condition.

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GLUTATHIONE IN THE TREATMENT OF CHRONIC FATTY LIVER DISEASES

Dentico P; Volpe A; Buongiorno R; Grattagliano I; Altomare E; Tantimonaco G;

o G; Sacco R; Schiraldi O; Istituto Policattedra, Università, Bari.

Recenti Prog Med( in Italian ), 1995 Jul-Aug, 86:7-8, 290-3

In chronic steatosic liver disease, alcohol or non-alcohol related or HBV,

HCV, HDV associated, a reduction in hepatic glutathione and, consequently, in

the detoxifying effects of hepatocytes is observed. Intravenous

administration of high dose glutathione in patients with chronic steatosic

liver disease has shown that glutathione significantly improves the rate of

some hepatic tests (bilirubin, GOT, GPT, GT) even several months after

treatment interruption. Further confirmation of the efficacy of GSH treatment

is provided by the reduction of malondialdehyde, a marker of hepatic cell

damage. The optimal results obtained in patients receiving 1800 mg/die/i.v.

advocate the use of this high dosage.

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PATHOGENESIS-SCREENING TESTS FOR LIVER DYSFUNCTION IN THE ASYMPTOMATIC

PATIENTS WITH ELEVATED ALT VALUES AND THEIR DIAGNOSTIC EFFICACIES IN PRIMARY

CARE MEDICINE

Takemura Y; Kobayashi H; Kamachi M; Sekiguchi S; Shioikari M; Tamura

M;Department of Laboratory Medicine, National Defense Medical College,

Tokorozawa, Japan. Rinsho Byori( in Japanese ), 1996 Mar, 44:3, 261-6

We have evaluated the diagnostic efficacies of ultrasonography and hepatitis

C virus (HCV) antibody measurement to differentiate pathogenesis of liver

dysfunction in the asymptomatic adults with elevated ALT value. Among 4256

visitors to PL Tokyo Health Control Center for their health examination, 463

cases (11%) showed abnormal liver function including elevation of ALT value.

Ultrasonography and HCV antibody measurement using the second generation

reagent had been applied to 362 cases in order to screen the etiology of

liver dysfunction. The ultrasonography succeeded to establish the diagnosis

of fatty liver in 137 cases (38%) and 41 cases (11%) demonstrated positive

HCV antibody. There were 4 cases with positive HBs antigen, however, it was

found that their abnormal liver function was attributed to other etiology

such as fatty liver and alcoholic liver dysfunction rather than chronic type

B hepatitis. HCV antibody-positive cases showed higher levels of total

protein, ZTT, AST, ALT, and lower levels of albumin, A/G, total cholesterol,

triglyceride, gamma-GT and cholinesterase value than other cases. HCV

antibody titers were not correlated to hepatic parenchymal damage estimated

by ALT or cholinesterase value. Only a little correlation was observed

between HCV antibody titers and HCV-RNA amounts determined by the competitive

reverse transcription-polymerase chain reaction (RT-PCR) method. These

results indicate sufficient diagnostic efficacies of ultrasonography and HCV

antibody measurement for a pathogenesis differentiation in the asymptomatic

patients with liver dysfunction, and these examinations should be employed as

the first-step screening tests for the etiology determination of liver

diseases in the primary care medicine.

hope this is of help....Joanne C.

[Guest guest]

Marcie-could you please describe the way you do the Yoga " Breath of FIre? "

Sounds interesting-be specific in your description please! Thanks, Marilyn

Glad you are doing so well!

[Guest guest]

Hi,

My computer crashed, so I am behind in my readings, but, my soap line is Tea

Bar Soaps! I use tea as substitutes for the water in the lye mix.. Which

lists are you referring to?

j

jmission@...

Flower Child Aromatherapy

> Message: 12

> Date: Fri, 4 Aug 2000 13:57:35 -0400

> From: A <vickielusk@...>

> Subject: teas

>

> could someone explain please I hear on this list and other using tea in

> making soap ... are we talking about tea

> as in the stuff we drink ..... If so how do you use it.....

> Best Wishes

> Vickie

> MySon's American Alpines,

> Homepage: http://home.att.net/~mlusk/index.html

> vickielusk@...

>

> ________________________________________________________________

> YOU'RE PAYING TOO MUCH FOR THE INTERNET!

> Juno now offers FREE Internet Access!

> Try it today - there's no risk! For your FREE software, visit:

> http://dl.www.juno.com/get/tagj.

>

>

>

[Guest guest]

Hi everyone, I am a new member, I have been on the ER4YT diet for 2yrs. I am

still working on my breakfast foods as well. I noticed several of you are as

well. My latest discovery is to cut sweet potatoes into large match stick size

pieces and stir fry them in Olive oil until they are tender. They are sweet and

a good carb for us!

Thanks to everyone for your thoughts and ideas on this site.

[Guest guest]

welcome

Wow - you have been at it 2 years already therefore we should be able to learn a

lot from you.

Looking forward to what you can share with us.

Have perhaps discovered a way to make yogurt using rice milk? Hope so as both

Helen from Australia and myself are looking for a recipe.

Best wishes

Elize

South Africa

>>> kklub@... 08/23/00 12:44AM >>>

[Guest guest]

In a message dated 08/23/2000 2:09:11 AM Eastern Daylight Time,

Elize.Combrink@... writes:

<< Have perhaps discovered a way to make yogurt using rice milk? Hope so as

both Helen from Australia and myself are looking for a recipe. >>

I plan to try some of the techniques I have used making yogurt and soy

yogurt. Stay tuned.

Betsy

[Guest guest]

Thanks Betsy

Best wishes

Elize

South Africa

>>> estewartso@... 08/24/00 02:13AM >>>

[Guest guest]

> I couldn't agree more about how important OT can be. I'm wondering if you

> and I go to the same one because mine also does EI and is GREAT. She is

> Patti

> Faller located in Livingston, NJ.

We used Patty for EI as well and LOVED her!!! Please send our regards!!

Stacey Abenstein

[Guest guest]

Here's another link for information, support and chat.

http://forums.about.com/Hepatitis Cen1/start

[ ] Digest Number 350

[Guest guest]

What a great group of people you all are! Thanks for all your

replies. I am due to take my first pill on Saturday (wanted to wait

til I had a few days off in a row in case I got "icky belly") I will

drink lots of water and hope for the best.

, hang in there hon. Get the rest you need at any cost hon,

your family needs you around as well.