AIM： To study liver biopsy practice over two decades in a district general hospital in the United Kingdom.METHODS： We identified all patients who had at least one liver biopsy between 1986 and 2006 from the database...AIM： To study liver biopsy practice over two decades in a district general hospital in the United Kingdom.METHODS： We identified all patients who had at least one liver biopsy between 1986 and 2006 from the databases of the radiology and gastroenterology departments. Subjects with incomplete clinical data were excluded from the study.RESULTS： A total of 103 liver biopsies were performed. Clinical data was available for 88 patients, with 95 biopsies. Between 1986 and 1996, 18 （95%） out of the 19 liver biopsies performed were blind and 6 （33%） were for primary biliary cirrhosis. Between 1996 and 2006, 14 （18%） out of 76 biopsies were blind; and the indications were abnormal liver tests （33%）, hepatitis C （12%） and targeted-biopsies （11%）. Liver biopsies were unhelpful in 5 （50） subjects. Pain was the most common complication of liver biopsy （5%）. No biopsy-related mortality was reported. There was a trend towards more technical failures and complications with the blind biopsy technique.CONCLUSION： Liver biopsies performed in small district hospitals are safe and useful for diagnostic and staging purposes. Abnormal liver tests, non-alcoholic fatty liver disease and targeted biopsies are increasingly common indications. Ultrasound-guided liver biopsies are now the preferred method and are associated with fewer complications.展开更多
Having cholesterol in our body is essential for living healthy,but too much can lead to serious health problems,including-but not limited to-heart attacks and strokes(1).Indeed,accumulating evidence points to choleste...Having cholesterol in our body is essential for living healthy,but too much can lead to serious health problems,including-but not limited to-heart attacks and strokes(1).Indeed,accumulating evidence points to cholesterol as a cancer risk factor especially in colon,rectal,prostatic and testicular cancer(2).Cholesterol is the most abundant sterol in animal tissues with many important functions that spans from simply maintaining cell membrane physical properties to the production of bile acids and biosynthesis of steroid hormones.For the most part,cholesterol is synthetised de novo in the liver,but some is obtained from dietary intake.The synthesis of cholesterol takes place in the cytoplasm and the endoplasmic reticulum(ER)of hepatocytes(the major liver cell types)and starts with one molecule of acetyl-CoA.展开更多
Non-alcoholic fatty liver disease(NAFLD)is a global public health problem and is the most common cause of chronic liver disease worldwide.The prevalence of NAFLD is approximately 30%,irrespective of ethnicity,and para...Non-alcoholic fatty liver disease(NAFLD)is a global public health problem and is the most common cause of chronic liver disease worldwide.The prevalence of NAFLD is approximately 30%,irrespective of ethnicity,and parallels the exponential rise of the obesity and diabetes epidemics.The active inflammatory and cell injury component of NAFLD,known as non-alcoholic steatohepatitis(NASH),increases the risk of liver-related mortality by 5 to 10 times;but this is largely dependent on the extent of fibrosis(1,2).Despite this,cardiovascular disease(CVD)and extra-hepatic malignancy remain the commonest causes of death in these cohorts.Therefore,non-surprisingly the last decade has seen the clinical focus switch from NAFLD as a solitary organ entity to a multi-systemic disease.展开更多
文摘AIM： To study liver biopsy practice over two decades in a district general hospital in the United Kingdom.METHODS： We identified all patients who had at least one liver biopsy between 1986 and 2006 from the databases of the radiology and gastroenterology departments. Subjects with incomplete clinical data were excluded from the study.RESULTS： A total of 103 liver biopsies were performed. Clinical data was available for 88 patients, with 95 biopsies. Between 1986 and 1996, 18 （95%） out of the 19 liver biopsies performed were blind and 6 （33%） were for primary biliary cirrhosis. Between 1996 and 2006, 14 （18%） out of 76 biopsies were blind; and the indications were abnormal liver tests （33%）, hepatitis C （12%） and targeted-biopsies （11%）. Liver biopsies were unhelpful in 5 （50） subjects. Pain was the most common complication of liver biopsy （5%）. No biopsy-related mortality was reported. There was a trend towards more technical failures and complications with the blind biopsy technique.CONCLUSION： Liver biopsies performed in small district hospitals are safe and useful for diagnostic and staging purposes. Abnormal liver tests, non-alcoholic fatty liver disease and targeted biopsies are increasingly common indications. Ultrasound-guided liver biopsies are now the preferred method and are associated with fewer complications.
基金SP and CB acknowledge the research funding from Rosetrees Trust(M894)and Guts UK(DGO2019_02).
文摘Having cholesterol in our body is essential for living healthy,but too much can lead to serious health problems,including-but not limited to-heart attacks and strokes(1).Indeed,accumulating evidence points to cholesterol as a cancer risk factor especially in colon,rectal,prostatic and testicular cancer(2).Cholesterol is the most abundant sterol in animal tissues with many important functions that spans from simply maintaining cell membrane physical properties to the production of bile acids and biosynthesis of steroid hormones.For the most part,cholesterol is synthetised de novo in the liver,but some is obtained from dietary intake.The synthesis of cholesterol takes place in the cytoplasm and the endoplasmic reticulum(ER)of hepatocytes(the major liver cell types)and starts with one molecule of acetyl-CoA.
文摘Non-alcoholic fatty liver disease(NAFLD)is a global public health problem and is the most common cause of chronic liver disease worldwide.The prevalence of NAFLD is approximately 30%,irrespective of ethnicity,and parallels the exponential rise of the obesity and diabetes epidemics.The active inflammatory and cell injury component of NAFLD,known as non-alcoholic steatohepatitis(NASH),increases the risk of liver-related mortality by 5 to 10 times;but this is largely dependent on the extent of fibrosis(1,2).Despite this,cardiovascular disease(CVD)and extra-hepatic malignancy remain the commonest causes of death in these cohorts.Therefore,non-surprisingly the last decade has seen the clinical focus switch from NAFLD as a solitary organ entity to a multi-systemic disease.
