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Alcohol Related Diseases in Gastroenterology by W. K. Lelbach (auth.), Priv. Doz. Dr. med. Helmut Karl

By W. K. Lelbach (auth.), Priv. Doz. Dr. med. Helmut Karl Seitz, Professor Dr. med. Burkhard Kommerell (eds.)

Alcohol abuse ranks one of the commonest and likewise the main serious environmental risks to human well-being. Its value is heightened by means of the opportunity of prevention by way of removal of the behavior, even though, infrequently exerted. The occurrence of deleterious results on human healthiness has relentlessly risen some time past years for various components. They comprise migration of populations and, relatively, elevated urbanization. therefore, in a few components of the area, inhabitants teams formerly spared became concerned, that is additionally re­ flected within the expanding variety of breweries and distilleries within the constructing international locations. Social, non secular, and gender-related boundaries to alcohol intake are loosening, and the monetary development of a few segments of populations now let them to shop for alcoholic drinks. hence the best percent upward thrust within the usa has lately been in black ladies. youth and youngsters drink extra alcoholic drinks than ever, and becoming alcohol abuse via pregnant girls has allow to a rise of the occurrence of the fetal alcohol syndrome. whereas the social and behavioral, together with psychiatric, outcomes of alcoholism are impressive, the gastrointestinal and, fairly, hepatic manifestations are the main frequent somatic results, and protracted hepatic disorder in alcoholics seems to be to reason the best price to society. certainly, mortality from liver cirrhosis is taken into account a competent index of alcohol intake in a country.

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N Engl J Med 307: 1598-1602 Ethanol Metabolism and Pathophysiology of Alcoholic Liver Disease 41 Farrell GC, Cooksley WGE, Hartand P, Powell LW (1978) Drug metabolism in liver disease. Identification of patients with impaired hepatic drug metabolism. Gastroenterology 75: 580-588 Feinman L, Lieber CS (1972) Hepatic collagen metabolism: effect of alcohol consumption in rats and baboons. Science 176: 795 Feinman L, Baraona E, Matsuzaki S, Korsten M, Lieber CS (1978) Concentration dependence of ethanol metabolism in vivo in rats and man.

Indeed, cytochrome P-450f was found recently by Leo et al. (1984) to display a selective capacity to metabolize retinoic acid to polar metabolites in a reconstituted system; in vivo, both ethanol and high A feeding appeared to increase this form of cytochrome (Leo et al. 1984), which has been newly discovered and purified (Iida et al. 1983; Ryan et al. 1984). Thus the toxicity could be related to the induction of the enzymes of the endoplasmic reticulum after chronic ethanol consumption. However, progression to severe parenchymal injury may offset the microsomal induction, as shown in baboons fed alcohol chronically (Lieber et al.

In the liver, the increased NADHINAD ratio raises the concentration of a-glycerophosphate (Nikkila and Ojala 1963), which favors hepatic triglyceride accumulation by trapping fatty acids (Johnson 1974). Hydrogen equivalents are also transferred into the mitochondria by various "shuttle" mechanisms (Fig. 2). Normally, fatty acids are oxidized via tJ-oxidation and the citric acid cycle of the mitochondria, which serves as "hydrogen donor" for the mitochondrial electron transport chain. When ethanol is oxidized, however, the generated hydrogen equivalents, which are shuttled into the mitochondria, supplant the citric acid cycle as a source of hydrogen.

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