This document discusses occupational liver disorders and their causes. It covers viral, chemical, and physically induced liver injuries and diseases. Some key points include:
1. The liver is divided into three zones (periportal, midzonal, centrilobular) that are differentially affected by toxins.
2. Occupational liver disorders are challenging to diagnose due to non-specific symptoms and potential simultaneous conditions like viral hepatitis or substance abuse.
3. Serologic markers and liver enzymes can help identify liver damage and its cause. Cytotoxic injuries elevate less liver-specific enzymes while cholestatic injuries increase enzymes like alkaline phosphatase.
4. Chemicals from many industries can cause liver
It is heavy metal and bright silvery in appearance.It is liquid and is non poisonous if swallowed. However, it volatilizes at room temp and inhalation of vapors is toxic. It gets widely distributed throughout the body and causes toxic damage to brain, kidney, peripheral nervous system, mucous membranes etc
It is heavy metal and bright silvery in appearance.It is liquid and is non poisonous if swallowed. However, it volatilizes at room temp and inhalation of vapors is toxic. It gets widely distributed throughout the body and causes toxic damage to brain, kidney, peripheral nervous system, mucous membranes etc
Toxicity is a function of solubility. Insoluble compounds as well as the metallic forms often exhibit negligible toxicity. The toxicity of any metal depends on its ligands. Heavy metal toxicity can result in damaged or reduced mental and central nervous function, lower energy levels, and damage to blood composition, lungs, kidneys, liver, and other vital organs.
How is a cell formed?
What is growth?
What is differentiation?
What is morphogenesis?
Growth disorders-
What is growth disorder?
Difference between growth and development.
Classification – hypertropy, hyperplasia
hypoplasia, atrophy
agenesis
metaplasia
dysplasia
neoplasia
Growth hormone – hypopituitarism
hyperpituitarism
Developmental disorder of orofacial structures – clefts
lip disorders
tongue
jaws
teeth
Public health significance
Toxicity and Detoxification with Far InfraredSarah Adams
A look at today's chemicals and heavy metals, their sources, our risk of exposure, and the harmful and even deadly health effects. Learn about your ONLY solution: Far Infrared Thermal Life Sauna by High Tech Health. In addition to whole body detoxification, far infrared supports significant benefits throughout the entire body.
- For the Mind: improves stress management, reduces fatigue, increases energy, boosts circulation, lessens depression and anxiety, stimulates focus and clear thinking, encourages positive mindset
- For the Nerve Supply: improves neurological health, increases cell and organ health and function, prevents spinal degeneration, reduces swelling and inflammation, supports healthy nervous system, improves spinal corrections
- For Nutrition: increases absorption of quality nutrition, enables proper cell function, promotes healthy diet, influences ideal weight and cellulite control, improves digestive problems, decreases cholesterol levels, decreases symptoms of diabetes, enhances heart health, increases basal metabolic rate
- For Oxygen and Lean Muscles: improves cardiovascular conditioning, strengthens regeneration and oxygenation, relieves pain and speeds up healing process, maximizes caloric burn, improves flexibility and range of motion, relieves fibromyalgia and arthritis, decreases muscle and joint pain, prevents injury
- For Detoxification: removes chemicals and heavy metals at the cellular level, eliminates toxic symptoms
Sarah Adams
High Tech Health International
Business Development Manager
800-794-5355
Toxicity is a function of solubility. Insoluble compounds as well as the metallic forms often exhibit negligible toxicity. The toxicity of any metal depends on its ligands. Heavy metal toxicity can result in damaged or reduced mental and central nervous function, lower energy levels, and damage to blood composition, lungs, kidneys, liver, and other vital organs.
How is a cell formed?
What is growth?
What is differentiation?
What is morphogenesis?
Growth disorders-
What is growth disorder?
Difference between growth and development.
Classification – hypertropy, hyperplasia
hypoplasia, atrophy
agenesis
metaplasia
dysplasia
neoplasia
Growth hormone – hypopituitarism
hyperpituitarism
Developmental disorder of orofacial structures – clefts
lip disorders
tongue
jaws
teeth
Public health significance
Toxicity and Detoxification with Far InfraredSarah Adams
A look at today's chemicals and heavy metals, their sources, our risk of exposure, and the harmful and even deadly health effects. Learn about your ONLY solution: Far Infrared Thermal Life Sauna by High Tech Health. In addition to whole body detoxification, far infrared supports significant benefits throughout the entire body.
- For the Mind: improves stress management, reduces fatigue, increases energy, boosts circulation, lessens depression and anxiety, stimulates focus and clear thinking, encourages positive mindset
- For the Nerve Supply: improves neurological health, increases cell and organ health and function, prevents spinal degeneration, reduces swelling and inflammation, supports healthy nervous system, improves spinal corrections
- For Nutrition: increases absorption of quality nutrition, enables proper cell function, promotes healthy diet, influences ideal weight and cellulite control, improves digestive problems, decreases cholesterol levels, decreases symptoms of diabetes, enhances heart health, increases basal metabolic rate
- For Oxygen and Lean Muscles: improves cardiovascular conditioning, strengthens regeneration and oxygenation, relieves pain and speeds up healing process, maximizes caloric burn, improves flexibility and range of motion, relieves fibromyalgia and arthritis, decreases muscle and joint pain, prevents injury
- For Detoxification: removes chemicals and heavy metals at the cellular level, eliminates toxic symptoms
Sarah Adams
High Tech Health International
Business Development Manager
800-794-5355
in this presentation me & my colleagues discuss briefly the types of mesenteric ischemia ( acute , chronic , venous ) and its related syndromes (superior mesenteric artery syndrome , celiac trunk syndrome and supply it by good radiologic images ..
Definition, Patterns/types and mechanisms of drug induced liver disorders, assessment of drug induced liver disorders and its treatment (pharmacotherapeutics-3)
Chronic liver disease, lecture presentation for 5th sem MBBS students. Introduction to chronic liver disease, notes on liver fibrosis, alcoholic hepatitis, liver histology and overview.
Healthcare organizations including hospitals were founded to give care to those who need it and to keep patients safe.
It is generally agreed upon that the definition of patient safety is…
"DO NO HARM"
Diet does not substitute drugs but it is considered a complementary therapy.
The goals of dietary advice are:
To prevent or manage some medical conditions
To maintain or improve health through the use of appropriate and healthy food choices
To achieve and maintain optimal metabolic and physiological outcome
Malnutrition is poor nutrition due to an insufficient, poorly balanced diet, faulty digestion or poor utilization of foods. (This can result in the inability to absorb foods).
Malnutrition is not only insufficient intake of nutrients. It can occur when an individual is getting excessive nutrients as well.
Adequate diet:
A mixture of food stuffs selected to satisfy the nutritional requirements of the body in quality and quantity. It should be safe and of good taste and smell. It should be suitable for weather age, effort and physiological status of every one.
Nutrition: it is the dynamic processes by which the body can utilize the consumed food for energy production, growth, tissue maintenance and regulation of body functions.
Is the ability to access, assess and apply the best evidence from systematic research information to daily clinical problems after integrating them with the physician's experience and patient's value.
Sample is Group of individuals or things selected from the entire population to be representative to this population.
Each member of the population is called the sampling unit.
Workplace Mental Health (WMH) is a sub-discipline concerned with psychological illness, injury and disability and the role of work as a causal or contributing factor. But, unfortunately, WHO announced that WMH is a ‘Cinderella’ subject. So, it is one of the most urgent demands facing the occupational health services (OHS).
Environment
Any things surrounding us & can affect health
Environmental sanitation
Properties & requisites of clean environment.
Environmental health
Protection of human health from hazards of unsanitary environment.
A training workshop that assists researchers in dealing with statistics throughout the research.
It is the science of dealing with numbers.
It is used for collection, summarization, presentation & analysis of data.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. Zone 1 (Periportal lobule): nearest the portal vein.
Zone 2 (Midzonal region): intermediate to the final region of liver.
Zone 3 (Centrilobular area): adjacent to the central vein.
3. Viral
hepatitis
Physical
agent-
induced
Chemical-
induced
1-Similarity of presenting symptoms (acute
toxic liver disorders frequently with
nonspecific clinical manifestations
2-Chronic liver injury usually are
asymptomatic until its end stage
3-Simultaneous conditions (viral hepatitis
and/or alcohol & drug abuse) confound
liver disorders caused by specific
occupational or environmental
hepatotoxins.
4-Host-susceptibility factors (genetic
polymorphisms of metabolic & detoxifying
enzymes)
4. SEROLOGIC MARKERS
•Serologic viral markers & their
antibodies & antigens.
•Reveals cause & stage of disease
Specific
pathogens
•Hepatic enzymes released into
blood.
•Indicates extent of hepatic injury
Liver
function
5. Cytotoxic hepatic injury
(a) Less specific enz. reflecting injury to
extrahepatic tissue (AST or SGOT & LDH)
(b) Enzymes mainly in the liver (ALT or
SGPT)
(c) Very specific enz. to the liver (ornithine
carbamyltransferase (OCT) & sorbitol
dehydrogenase (SDH).
Cholestatic injury
- Alkaline phosphatase (AP)
- 5'-nucleotidase (5'-NT)
- γ-glutamyltranspeptidase (γ-GT)
Serum alpha-fetoprotein is a
well-established marker for
hepatocellular carcinoma
(low specificity)
Serum enzymes
generally only elevated
with extrahepatic
diseases as, creatine
phosphokinase (CPK).
Serologic Markers
for Liver Function
8. INFLAMMATORY LIVER DISORDERS
Predominate cause of liver-related morbidity
The consequence of cumulative damage that leads to hepatocyte
death and recruitment of inflammatory cells to sites of injury.
Long-term conditions that may progress to cirrhosis & hepatic
failure due to a lack of effective early diagnostic & treatment
protocols.
The primary causes:
Viral: Hepatitis A,B,C,D,E, Yellow fever, Epstein-Barr virus,
Cytomegalovirus, four exotic viruses (Ebola, Marburg, Lassa
fever, and Rift Valley fever viruses), Herpes hominis, Rubella,
Adenoviruses, and Enteroviruses.
Other: Miliary tuberculosis, Malaria, Staphylococcal
bacteremia, Salmonelloses, Candida, and amebiasis.
20. MECHANISM OF TOXICITY
Intrinsic toxin (Dose-dependent):
Most hepatotoxins
Direct hepatotoxins:
- Direct physicochemical effect (peroxidation of membrane
lipids or denaturation of protiens) leading to hepatocyte
membrane destruction and distortion.
- CCL4, Chloroform, CBr4, Trichloroethan,Tetrachloroethylene.
-
- Hepatotoxic potential of Haloalkans:
- Inversely proportionate to chain length & bond energy.
- Directly proportionate to no. of halogen atoms in molecule &
atomic no. of halogen.
21. Indirect hepatotoxicity:
- Interference with metabolic pathway
Cytotoxic damage: Degeneration or Necrosis of
hepatocytes by interfering with pathway necessary for
structural integrity (steatosis or necrosis)
- Botanicals (aflatoxin, tannic acid) & drugs (tetracycline,
methotrexate)
Cholestatic damage: interfering with bile secretion
- Only one is MDA (Methylene dianiline)
22. Idiosyncratic toxin (Dose-independent):
- Few hepatotoxins
- e.g., Beryllium & Halothane
- Sporadic liver injury, possibly due to a
hypersensitivity or immunologic-type reaction.
26. Acute injury often results in an accumulation of
lipids (Steatosis) & appearance of degenerative
processes, leading to cell death (Necrosis).
Necrotic process can affect small groups of isolated
parenchymal cells (Focal necrosis), groups of cells
located in zones (Centrilobular, Midzonal, or
Periportal necrosis), or all cells within a hepatic
lobule (Massive necrosis).
ACUTE HEPATITIS
27. CHRONIC ACTIVE HEPATITIS
Chronic active hepatitis (CAH),(chronic aggressive hepatitis), is
one of the 3 major forms of chronic hepatitis.
The other two forms, chronic persistent hepatitis (CPH) and
chronic lobular hepatitis (CLH), are usually clinically mild and
histologically nonprogressive and, therefore, are considered benign.
CAH is frequently characterized by the development of symptoms
and abnormality of liver function or histologic status with a high
likelihood of progression to cirrhosis.
Causes: Infections with HBV, HCV, and HDV; Drug-induced,
Autoimmune reactions; Genetic metabolic disorders, & Occupational
or environmental exposures to certain Hepatotoxins & Alcohol.
31. 1. CHOLESTATIC INJURY
Diminution or cessation of bile flow and retention of bile
salts & bilirubin.
Clinical symptoms: Jaundice, abdominal pain, pruritus,
& fever
Rare but has been reported following exposure to the
chemical Methylene Dianiline (MDA), an aromatic
amine used as an epoxy resin hardener.
Epping jaundice (1965): Epidemic of Acute Cholestatic
Jaundice occurred in Epping, England, after bread was
made from flour contaminated with MDA.
32. Chronic cholestatic liver disorder
- The Spanish toxic oil syndrome (1981)associated
with accidental high ingestion of denatured rapeseed
oil.
- Patient with severe muscle wasting accompanied by muscle
and skin fibrosis, prominent features of the Spanish toxic oil
syndrome. Epidemiologic studies demonstrated that affected
subjects consumed a rapeseed oil containing fatty acid
anilides. Oil from France that had been deliberately
adulterated with aniline to prevent food use was illegally
intercepted in Spain, heated to remove the aniline, and sold in
and around Madrid in 1981.
33. 2. FATTY LIVER(STEATOSIS)
Morphologically as greater than 5% of the hepatocytes
containing fat or, Quantitatively, as greater than 5 g lipid per
100 g hepatic tissue.
Also occurs in other disorders (DM, hypertriglyceridemia,
& obesity).
Some degree of steatosis is usually found accompanying
acute hepatocellular necrosis; But, marked steatosis is
more commonly seen in exposure to chronic hepatotoxins.
34. First described with Yellow Phosphorus poisoning.
Chronic exposure to chlorinated solvents such as CCl4,
methyl chloroform.
Styrene, Toluene, Trichloroethane (TCE) & other aromatic
compounds.
TNT in munitions industries, Arsenical pesticide use in
vintners.
More subtle microsteatosis was described following short-
term, low-level exposure to dimethylformamide (DMF)
in a fabric-coating factory.
35.
36. 3- HEPATOPORTALSCLEROSIS
Rare form of noncirrhotic periportal fibrosis, which can lead
to Portal Hypertension.
Occupational exposure to the Vinyl Chloride Monomer
(VCM) in Polyvinyl Chloride (PVC) polymerization plants,
Inorganic Arsenicals, and Thorium compounds.
Liver histology has shown hyperplasia of hepatocytes and
sinusoidal cells, with dilatation of sinusoids and progressive
subcapsular, portal, perisinusoidal, and occasionally,
intralobular fibrosis, which is accompanied by portal
hypertension and splenomegaly.
37. 4- FULMINANTHEPATIC FAILURE & NECROSIS
Exposure to TNT (munitions manufacture during WWI & II).
CCl4 , chloroform, TCE, & epoxy resin coating containing 2-
nitropropane after inhalation exposure in an enclosed space.
A severe liver disorder in which hepatic insufficiency progresses
from the onset of symptoms to hepatic encephalopathy within 2 to
3 weeks, resulting in liver necrosis & liver failure.
The symptoms included jaundice, hepatomegaly, and severe liver
necrosis. Even people who survive the acute phases of the disease
often later develop postnecrotic cirrhosis or aplastic anemia.
Onset of symptoms developed 2 to 4 days after exposure, often
accompanied by renal failure in severe cases. Those who survived
the acute stages recovered in 2 to 4 weeks, but repeated subclinical
exposure could induce cirrhosis.
38. 5- CIRRHOSIS
A chronic, irreversible condition where the normal
lobular architecture is replaced by fibrous tissue and
regenerating nodules derived from the remaining
hepatocytes.
Mainly due to chronic viral infection & alcohol abuse
Organic Solvents, Dimethylnitrosamine (DMN), TNT,
TCE, pesticides, Arsenic , PCBs& Hydrazines.
Cirrhosis & other liver disorders have been reported to
be more prevalent among Anesthesiologists compared
to other hospital personnel.
Morticians exposed long term to formaldehyde had a
greater prevalence of cirrhosis, although ethanol was a
possible confounding factor.
39. 6- GRANULOMATOUSDISEASE OF THE LIVER
Beryllium and Copper.
In beryllium injury, the histopathologic appearance of the
liver biopsy specimen can be indistinguishable from
sarcoidosis. Berylliosis may include involve granulomas in
the spleen, bone marrow, and lungs, as well as the usual
granulomatous interstitial lung disease.
Vineyard sprayer's lung were found to be associated with
liver damage with inclusion of copper in biopsy tissue. The
liver disorder included proliferation & swelling of the
Kupffer cells, sarcoidlike granulomas, fibrosis, micronodular
cirrhosis, hepatic angiosarcomas, & idiopathic portal
hypertension.
40. The mildew of the vineyards is prevented by the use of
sprays with a solution of Copper Sulphate neutralized with
hydrated lime. The inhalation of this solution while spraying
may give rise to predominantly interstitial pulmonary lesions
which may lead to respiratory insufficiency.
41. 7- PORPHYRIA CUTANEA TARDA
Vinyl chloride-induced hepatic injury by the inhibition
of a number of hepatic enzymes in the porphyrin
biosynthesis pathway. Porphyrinuria due to vinyl
chloride exposure is rare.
Methyl chloride poisoning, Dioxin, HCB, 2,4,5-
trichloro-phenoxy acetic acid (2,4,5-T), PCBs & other
polyhalogenated aromatic hydrocarbon-induced liver
injury.
Following exposure to (TCDD), porphyria cutanea
tarda seems to be quite a specific disorder, producing
increased urinary concentrations of uroporphyrin.
42. 8- OTHER LIVER ABNORMALITIES
Transient increased values of liver function tests recorded
following occupational exposure to methylene chloride.
Increased transaminase values with exposure to (DMF)
dimethylformamide with microvesicular fat &
hepatocellular changes in liver biopsy specimens.
Liver biopsy of workers manufacturing pesticide Kepone
(chlordecone) showed increased fat, numerous dense
bodies & proliferative smooth endoplasmic reticulum, as
well as severe neurologic symptoms.
Jaundice & mild transient liver necrosis diagnosed in
exposed to Chrome during chrome-plating operations.
43. Transient liver function abnormalities were also found in
association with TCDD exposure. 10% of the Seveso
(Italy) population environmentally exposed to TCDD after
an industrial explosion had modest elevations of γ-GT.
Separately, workers exposed to tetrachlorophenol (TCP) &
TCDD had prolonged prothrombin time and elevated
plasma lipid & other liver transaminase values. Mild
steatosis, periportal fibrosis, activation of Kupffer cells &
porphyria cutanea tarda were reported in workers who
manufactured TCDD.
44. In Japan and Taiwan, more than 2,000 people who
ingested cooking rice oil contaminated with PCB
and related compounds had abnormal liver function
tests, hepatomegaly in severe cases, and electron
microscopic alterations in the endoplasmic
reticulum and mitochondria in biopsy samples.
45. Increased hepatic enzyme values (especially γ-GT &
ALT) were seen in human populations who
consumed water from a reservoir contaminated with
a heavy bloom of the toxic blue-green alga,
Microcystis aeruginosa, compared to an adjacent
population who drank water from other sources.
Toxic hepatitis outbreak occurred in India in 1974
and Kenya in 2004 with a high mortality. These
incidents were associated with food contamination
with aflatoxin & other mycotoxins.
48. Exposure to a cumulative dose of Ionizing Radiation in
excess of 3,000 to 6,000 rad gives rise to radiation-
induced hepatitis 2 to 6 weeks later.
Those who survived often subsequently develop
cirrhosis with progressive fibrosis & obliteration of the
central veins with centrilobular congestion.
Radiation-induced hepatitis has been reported after
intense accidental exposure.
50. There are two types of human malignant liver
disorders associated with occupational &
environmental hepatotoxicants,
1. Hepatocellular carcinoma (HCC).
2. Hepatic angiosarcoma (HAS) (Endothelial cell
sarcoma).
52. HEPATIC ANGIOSARCOMA (HAS)
A rare malignant tumor.
Associated with chronic exposure to VCM, Arsenic,
Anabolic Steroids, & Thorotrast (an obsolete
scintigraphy contrast agent that contained colloidal
thorium dioxide, an emitter of α-particle ionizing
radiation).
Vineyard workers & others who used arsenicals,
including Fowler's solution (1% potassium arsenite), or
copper as a pesticide.
Long-term ingestion of Arsenic-contaminated well
water.
53. HEPATOCELLULAR CARCINOMA (HCC)
One of the most common cancers worldwide,
with a striking geographic variation in incidence.
In China, accounts for over 300,000 deaths
annually & this is the 3rd leading cause of cancer
mortality.
54.
55.
56. The two major HCC risk factors, HBV & aflatoxin B1
(AFB1) exposure.
Presence of aflatoxin-nucleic acid adduct (AFB-N7-gua)
in urine always resulted in 2-3 fold increase in HCC risk.
A dose-response relationship between urinary aflatoxin
M1 (AFM1) levels & HCC in chronic HBV carriers.
Mutations in the p53 tumor suppressor gene
57. The p53 gene is found mutated in a majority of
human cancers, and there is a large variation in
number and type of mutations between cancers of
different tissues.
"molecular fingerprint" in the p53 gene is a
characteristic G→T transversion at the 3rd base
of codon 249 observed in liver cancer patients
from regions of high aflatoxin exposure (50% of
HCCs).
58.
59.
60. BIOMARKERS & HBV INFECTION IN LIVER CANCER
A double mutation in the HBV genome, an
adenine to thymine transversion at nucleotide
1762 and a guanine to adenine transition at
nucleotide 1764 (1762T/1764A), has been found
in HCCs