The zonal distribution of megamitochondria with crystalline inclusions in nonalcoholic steatohepatitis.

Megamitochondria with crystalline inclusions (MMC) have been previously described in nonalcoholic fatty liver; however, their distribution within hepatic zones is unknown. We sought to determine this distribution from the core liver biopsy specimens of 31 patients: 8 males and 23 females, age range 21 to 72 years. Twenty-nine showed evidence of nonalcoholic steatohepatitis (NASH) on biopsy with steatosis, inflammation, varying degree of fibrosis, ballooned hepatocytes, and Mallory hyaline, and two patients had cryptogenic cirrhosis thought to represent "burned out" NASH.

N-2-butyl-cyanoacrylate for bleeding gastric varices: a United States pilot study and cost analysis.

Objectives: N-butyl-2-cyanoacrylate has been reported to be effective for bleeding varices but is not available in the United States. We report the initial US experience with cyanoacrylate in this prospective trial and evaluate its safety, efficacy, and relative costs.

Methods: Patients with active or recent gastric variceal bleeding were eligible.

Recombinant activated factor VII for coagulopathy in fulminant hepatic failure compared with conventional therapy.

Severe coagulopathy in fulminant hepatic failure (FHF) is difficult to correct by conventional means. Recombinant activated factor VII (rFVIIa) is an antihemophilic factor that has shown promise in treating coagulopathy in liver disease. Our aim is to review our experience with rFVIIa in treating the coagulopathy of FHF and compare these results with those of conventional therapy.

Subacute liver failure in obese women.

Objectives: Steatosis or steatohepatitis, common conditions associated with obesity, are usually considered to be stable or only slowly progressive. We have encountered a small number of patients with a history of obesity and a subacute course of liver failure over a period of 4-16 wk from the onset of symptoms. The patients had findings suggestive of an acute exacerbation of previously unrecognized nonalcoholic steatohepatitis (NASH).

Is NASH underdiagnosed among African Americans?

Objective: Obesity and type 2 diabetes mellitus are considered risk factors for nonalcoholic steatohepatitis (NASH) and cryptogenic cirrhosis. Because obesity and type 2 diabetes are prevalent among African American females by the 5th and 6th decades, one would expect an increased number of African Americans among patients with NASH and cryptogenic cirrhosis.

Methods: We determined the percentage of patients of African American and European American descent among all of the patients in our liver disease registry and those with NASH and cryptogenic cirrhosis.