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Original Articles
- Alcoholic Type Cirrhosis Following Side to Side Ileo-Transverse Colon Anastomosis.
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Kwang Hwa Park, Kwang Hyup Han, Chan Il Park
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Korean J Pathol. 1990;24(2):148-152.
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Abstract
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- A case of micronodular cirrhosis of the alcoholic type developed following an intestianl bypass surgery in a 47 year-old nonalcoholic male patient is presented. The patient denied any drug use of a long duration and had no diabetes mellitus. Five years before, a side to side ileo-transverse colon anastomosis had been performed for perforated intestinal tuberculosis at 1 m proximal to the ileocecal valve, bypassing a short segment of ileum (about 1.5 m) and transverse colon. The ileum distal to the perforated site had been found completely stenosed. He was severely lean with evidences of nutritional deficiency such as low serum levels of the albumin and vitamin B12. The liver biopsy showed a fatty change, Mallory bodies and perihepatocellular collagenosis within the cirrhotic nodules. The present case suggests that, when there are blind loop formation and nutritional deficiency, hepatic changes identical to those following jejunoileal bypass could develop even by reduction of a shore segment of the small intestine.
- Histologic Pattern of Alcoholic Liver Disease in Korea.
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Chan Il Park, Ho Guen Kim, So Young Jin, Mi Kyung Lee, Yoo Bock Lee
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Korean J Pathol. 1989;23(3):292-304.
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Abstract
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- To elucidate the histologic pattern of alcoholic liver disease (ALD) in Korea, liver biopsies from 173 chronic alcoholics with clinical liver diseases were classified according to the pathologic parameters. One hundred and seventeen cases, the sum of 91 of 116 serum HBsAg negative and 26 of 57 HBsAg positive patients, had the histologic evidence of ALD. Fatty change(23.9%), alcoholic fibrosis (AF)(23.1%) and cirrhosis (23.1%), comprised the three major ALDs, and only 8.5% of cases fit the criteria of alcoholic hepatitis. Chronic sclerosing hyaline disease (CSHD), chronic active alcoholic hepatitis (CAAH) and AF, where non-cirrhotic fibrosis is the predominant change, comprised 44.5% of ALD. Both features of ALD and HBV liver disease (HBV-LD) were found in 17 cases that included 8 AF and 7 cirrhosis. These 17 patients tended to consume less alcohol than patients with other types of pure ALD except alcoholic heaptitis. Patients with the serum HBsAg positive ALD (37.4years) were about 8 years younger than those with the serum HBsAg negative ALD (45.1years). More or less fatty change and foamy degeneration were seen in 77.4% and 31.6% of ALD respectively. Mallory bodies, megamitochondria, iron deposition and perihepatocellular fibrosis were found in 20.5%, 29.9%, 42.7% and 77.8%, respectively. These findings indicate that non-cirrhotic chronic ALD such as CSHD, CAAH and AF are the important histologic patterns of ALD in Korea, and that chronic alcohol consumption and HBV may act synergistically in developing liver disease.
- A Clinicopathologic Study on Chronic Alcoholic Hepatitis.
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Gi Yeong Huh, Sun Kyung Lee
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Korean J Pathol. 1988;22(4):393-403.
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Abstract
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- This study was undertaken to evaluate the significant diagnostic points of chronic alcoholic hepatitis (CALH) among clinicopathologic findings observed. The specimens used in this study were 20 cases of CALH and 28 cases of chronic active viral hepatitis (CAVH), which were diagnosed at our University Hospital during 9 years period from 1978 to 1987. In these cases, comparative analysis of age and sex distribution, major clinical manifestations, and laboratory and histopathologic findings was performed. The results obained were summarized as follows: Among 20 cases of CALH, the sex distribution was 15 in male and 15 in female with a ratio of 3:1. The range of age distribution was wide from third to seventh decade. There was no recognizable special point about the age and sex distribution of CALH, compared with cases of CAVH. Major clinical manifestations of CALH were hepatomegaly (85%), jaundice (75%) and abdominal pain (50%). Also there was no recognizable special point about the major clinical manifestations of CALH, compared with cases of CAVH. Abnormal values of major laboratory items in CALH were observed in activities of serum r-GTP (100%), SGOT (95%), SGPT (75%) and serum alkaline phosphatase (60%), and total serum bilirubin (60%). Compared with CAVH in major laboratory findings, the significant diagnostic items of CALH were the activities of serum r-GTP and alkaline phosphatase. The characteristic histopathologic findings of CALH, which were compared with CAVH and observed in liver parenchyma, were fatty change (100%), cytoplasmic ballooning and coagulation (100%), delicate fibrosis (85%), bile stagnation (35%), and Mallory bodies (20%), and that observed blurring of limiting plate (60%) in portal and periportal areas.
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