Effect of lifetime alcohol consumption on the histological severity of non‐alcoholic fatty liver disease

Background & Aims Non‐alcoholic fatty liver disease ( NAFLD ) is defined based on recent alcohol consumption; however, remote or lifetime alcohol consumption is not taken into account. It is not known whether lifetime alcohol consumption contributes to the severity of disease in patients with NAFLD . To determine the effect of lifetime alcohol consumption on the histological severity in patients with NAFLD . Patients & Methods Adults >18 years of age with presumed NAFLD and alcohol consumption <40 g/week were enrolled. Lifetime alcohol consumption was determined using a questionnaire. Patients with a history of long‐term alcohol abuse or dependence were excluded. A liver biopsy was reviewed by a single pathologist in a blinded fashion. Demographic, clinical and histological findings were compared in those who had regular alcohol consumption and those who did not. Results A total of 77 patients had fatty liver on biopsy. Fifty‐two patients had a history of regular alcohol consumption. The median lifetime cumulative alcohol intake was 24 gram‐years. On multivariable analysis, increasing age ( OR 1.07, 95% CI 1.01–1.14) was associated with severe liver disease, whereas alcohol consumption of ≥24 gram‐years was associated with less severe disease ( OR 0.26, 95% CI 0.07–0.97, P  = 0.04). Patients who continued to consume alcohol or had been abstinent for ≤1 year had less severe disease. Conclusion Some degree of regular alcohol consumption over the course of a lifetime compared to minimal intake appears to have a protective effect on the histological severity of liver disease among patients with strictly defined NAFLD .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102218/1/liv12230.pd

CD73 (ecto‐5′‐nucleotidase) hepatocyte levels differ across mouse strains and contribute to mallory‐denk body formation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100334/1/hep26525.pd

Liver transplantation for alcoholic cirrhosis: Long term follow-up and impact of disease recurrence

Background. Alcoholic liver disease has emerged as a leading indication for hepatic transplantation, although it is a controversial use of resources. We aimed to examine all aspects of liver transplantation associated with alcohol abuse. Methods. Retrospective cohort analysis of 123 alcoholic patients with a median of 7 years follow-up at one center. Results. In addition to alcohol, 43 (35%) patients had another possible factor contributing to cirrhosis. Actuarial patient and graft survival rates were, respectively, 84% and 81% (1 year); 72% and 66% (5 years); and 63% and 59% (7 years). After transplantation, 18 patients (15%) manifested 21 noncutaneous de novo malignancies, which is significantly more than controls (P=0.0001); upper aerodigestive squamous carcinomas were over-represented (P=0.03). Thirteen patients had definitely relapsed and three others were suspected to have relapsed. Relapse was predicted by daily ethanol consumption (P=0.0314), but not by duration of pretransplant sobriety or explant histology. No patient had alcoholic hepatitis after transplantation and neither late onset acute nor chronic rejection was significantly increased. Multiple regression analyses for predictors of graft failure identified major biliary/vascular complications (P=0.01), chronic bile duct injury on biopsy (P=0.002), and pericellular fibrosis on biopsy (P=0.05); graft viral hepatitis was marginally significant (P=0.07) on univariate analysis. Conclusions. Alcoholic liver disease is an excellent indication for liver transplantation in those without coexistent conditions. Recurrent alcoholic liver disease alone is not an important cause of graft pathology or failure. Potential recipients should be heavily screened before transplantation for coexistent conditions (e.g., hepatitis C, metabolic diseases) and other target-organ damage, especially aerodigestive malignancy, which are greater causes of morbidity and mortality than is recurrent alcohol liver disease

The gut microbiome and nonalcoholic fatty liver disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139925/1/cld671.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139925/2/cld671_am.pd

IL28B genetic variants and gender are associated with spontaneous clearance of hepatitis C virus infection

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90125/1/j.1365-2893.2011.01497.x.pd

Solder Ball Reliability Assessment of Wafer Level Chip Scale Package (WLCSP) Through Power Cycling

Failure analysis and its effects are major reliability concerns in electronic packaging. More accurate fatigue life prediction can be obtained after the consideration of all affecting loads on the electronic devices. When an electronic device is turned OFF and then turned ON multiple times, it creates a loading condition called Power Cycling. The die is the main heat source causing non-uniform temperature distribution. The solder ball reliability assessment of wafer level chip scale package (WLCSP) is done through computational methods such as Finite element analysis. WLCSPs use wafer level package technology which is an extension of the Wafer Fab process, where the final device is a die with an array pattern of the solder interconnects. In this paper, the reliability of solder balls is determined by subjecting the board to Power Cycling and estimating the stress and failures. The mismatch in Coefficient of Thermal Expansion (CTE) between components used in WLCSP and the non-uniform temperature distribution between them, leads to the deformation of the package. Analysis is done on different thicknesses of the board to study its effect on reliability

Meta‐analysis: IL ‐28 B genotype and sustained viral clearance in HCV genotype 1 patients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92057/1/apt5145.pd

Meta-analysis: insulin sensitizers for the treatment of non-alcoholic steatohepatitis

Aliment Pharmacol Ther 2010; 32: 1211–1221Non-alcoholic fatty liver disease generally has a benign course; however, patients with non-alcoholic steatohepatitis (NASH) may progress to cirrhosis and hepatocellular carcinoma. Currently, there is a lack of consensus about optimal NASH treatment.To assess the efficacy of insulin-sensitizing agents on histological and biochemical outcomes in randomized control trials of biopsy-proven NASH.Multiple online databases and conference abstracts were searched. Random effects meta-analyses were performed, with assessment for heterogeneity and publication bias.Nine trials were included; five trials using thiazolidinediones (glitazones), three using metformin and one trial using both drugs. There was no publication bias. Compared with controls, glitazones resulted in improved steatosis (WMD = 0.57, 95% CI 0.36–0.77, P  = <0.001), hepatocyte ballooning (WMD = 0.36, 95% CI 0.24–0.49, P  < 0.001) and ALT (WMD = 16.4, 95% CI 7.7–25.0, P  < 0.001), but not inflammation ( P  = 0.09) or fibrosis ( P  = 0.11). In patients without diabetes, glitazones significantly improved all histological and biochemical outcomes, most importantly including fibrosis (WMD = 0.29, 95% CI 0.078–0.51, P  = 0.008). Metformin failed to improve any pooled outcome.Treatment of NASH with glitazones, but not metformin, demonstrates a significant histological and biochemical benefit, especially in patients without diabetes. Additional studies are needed to investigate long-term outcomes of glitazone therapy in patients without diabetes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79251/1/j.1365-2036.2010.04467.x.pd

Occult hepatitis B virus infection: A hidden menace?

No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34784/1/510340128_ftp.pd