Anatomy

There are many things that affect the human body and attack its defence systems,they can be naturally occouring in the environment or self inflicted or caused by societys pollution of our planet. Below are some conditions, with the effects that they cause to the human body and its defence mechanisms. Alcohol consumption is a health issue which affects the vast majority. A great many people drink alcohol regularly. Although they may not be alcoholic in the sense of being addicted to alcohol, they neverthelesss expose themselves to health risks. The alcohol in wines, beers and spirits is a depressant of the central nervous system.

Small amounts gives a sense of well-being, with a realease from anxiety. However, this is accompanied by a fall-of in performance in any activity requiring skill. It also gives a misleading sense of confidence. The drunken driver usually thinks he or she is driving very well. Even a small amount of alcohol in the blood increases our reaction time. In some people, the reaction time is doubled even when the alcohol in the blood is well below the legal limit laid down for car drivers. This can make a big differenece in the time needed for a driver to apply the brakes after seeing a hazard.

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Alcohol reduces inhibitations and it can lead to irresponsible behaviour such as vandalism and aggression. Alcohol causes vaso-dilation in the skin, giving sense of warmth but in fact leading to a greater loss of body heat. A concentration of 500mg of alcohol in 100 cubic cm of blood results unconsciousness. More than this will kill, by stopping the action of the breathing centre in the brain. High doses of alcohol can harm virtually every organ in humans body. Many of these effects are reversible with abstinence, others are not. (2) Esophagus. Alcohol is associated with nearly half of the cancers of the esophagus, mouth, and larynx.

Peole who vomit too intensely after getting drunk can cause tears in their esophagus. Brain. Alcohol depresses the central nervous system and contracts brain tissue. It destroys brain cells – which unlike many other types of cells in the body, do not regenerate. Taken in large amounts over a long period of time, alcohol can cause serious problems with cognition and memory. Heart. Heavy drinking can cause heart disease, stroke, high blood pressure and heart failure. Even social drinkers who binge on special occasions can sometimes get bouts of irregular heartbeats. Lungs.

Heavy drinkers have more pulmonary infections and can be more susceptible to pneumonia and lung collapse. As intoxicated person loses his reflexses and can’t clear his airway when he vomits. Stomach contents may get sucked into the lungs, which can lead to choking or pneumonia. Liver. Liver damage often begins with a fatty liver, and may progress to alcoholic hepatitis. That may be followed by the buidup of scar tissue known as cirrhosis. Cirrhosis can change the structure of the liver and choke off blood flow. This can cause varicose veins, which can rupture, triggering catastrophic bleeding. Stomach.

Alcohol irritates the stomach, and can cause gastritis, ulcers and acid reflux. Gastritis is an inflamation of the mucous membrane that lines the stomach. Erosion in that lining can cause constant oozing of blood into the stomach or, if a vessel ruptures, major bleeding. Kidneys. Alcohol is a diuretic that increases urine output. Prolonged heavy drinking can cause kidney failure. Small intestines ; pancreas. Alcohol blocks the absorption and breakdown of nutrients by damaging the cells lining the stomach and intestines, and by decreasing the amount of digestive enzymes secreted by the pancreas.

The pancreas can become inflamed and leak digestive enzymes, which then attackthe pancreas itself. Reproductive system. In men, it impairs the production of and testosterone, and can lead to interfility and impotance. In women, the effect can be decreased estrogen metabolism in the liver which increases the amount of estrogen circulating the body, which can contribute to menstrual irregularities and even interfility. Blood. Prolonged alcohol abuse can cause anemias and abnormal blood clotting, which results in excessive bleeding and easy bruising.

It also impairs the functionof white blood cells, increasing susceptibility to infection. Joints ; muscles. Alcohol dependence can cause osteoporosis ; arthritis, and deform the joints. It can atrphy muscles and cause acute muscle pain and weakness. Skin. Alcohol causes the small blood vessels in the skin to dilate(open), which results in a rush of warm blood to the surface. This makes the skin look flushed and gives the person a false feeling of “being hot”. (13) Heavy drinking during pregnancy can lead to deformed babies. Alcohol can cross the placenta and damage the foetus.

Pregnant women who take as little as one alcoholic drink a day are at risk of having babies with lower than average birth weights. These under-weight babies are more likely to become ill. All levels of drinking are thought to increase the risk of miscariage. (1) The affects of alcohol vary with different people. Alcohol is a drug and must be handled with care. Knowing its uses and abuses is just imporatnt as reading the instructions on a bottle of pills. It is basic preventive medicine to know how your body handlers alcohol, how much is safe to drink, and, finally, how your body gets rid of it.

When people drink small of alcohol enters directly into bloodstream through the lining of the mouth and throat. The remaining amount of alcohol is absorbed by the stomach or intestine. At this point the alcohol is then dispersed uniformly throughout the body. Its effects are similar to ether or chloroform, affecting all part of the body controlled by the brain. The ability to make appropriate judgements and to exercise self-control is affected. Alcohol must be broken down in order to leave the system. More than 90 percent of the alcohol is oxidized in the liver and the remainder is discharged through the lungs and kidneys.

It takes just as long for the experienced drinker to eliminate alcohol as it does for the inexperienced drinker. (15) Ultraviolet light is a part of the light spectrum that is invisible to the human eye. Part of sunlight is UV light, which creates warmth, light, photosynthesis in plants, and vitamin D synthesis in the body. The sun produces about three types of UV lights: UVA, UVB, UVC. The ozone layer filters out UVC. UVA, however, has a long wavelenght light, so a certain amount reaches the earth’s surface. UVA is the predominant light to reach earth.

UVA causes damage to cellular membranes and DNA, and has been implicated in ageing of the skin and the development of skin cancer. Scientists believe it is UVB lights that are the paramount cause of premature ageing of skin, sunburn, skin cancers and other skin problems, despite the fact that UVB lights constitute for only 1% of UV lights that reach our skin. (4) UV light is beneficial for people and essential in the production of vitamin D, which is absorbed into the bloodstream and nourishes and helps to maintain bone tissue. Also UV light activates the pigment melanin in the skin, and thereby creates a tan.

Many people feel better when they have a tan, as it gives a healthy appearance. It is also used to treat several diseases, including rickets, psoriasis, eczema and jaundice. This takes place under medical supervision and the benefits of treatment versus the risk of UV light exposure are matter of clinical judgement. Ultraviolet light can be harmful to humans. Prolonged human exposure to UV light may result in acute and chronic health effects on the skin, eye and immune system. (3) Sunburn (erythema) is the best known acute effect of excessive UV light exposure.

Over the longer term, UV light induces degenerative changes in the cells of the skin, fibrous tissues and blood vessels leading to premature skin ageing, photodamage and actinic keratoses. Sun-damaged skin develops a thickened epidermis. This is caused by faster cell renewal, which is part of the immediate defence mechanism of the skin. The epidermis will return to normal provided the skin is not repeatedly over- exposed. Constant exposure to sunlight causes the melanocytes to become chronically over-active, resulting areas of excessive melanin in the skin.

Eventually, areas of damaged skin made up of increased numbers of melanocytes and increased melanin synthesis develop. Up to around 85% of the overall appearance of ageing makes photoageing. It is a slow process and proceeds for several decates before it becomes obvious. The degree of photoageing is determined by the skin type and by the total lifetime sun exposure. People who spend their lives almost entirely indooors show very little skin damage. The degree of damage to tissues in different regions of the body is directly propotional to the amount of sunlight received.

In chronically sun-damaged skin the epidermis as a whole becomes thicker, and loses some of its undulations. This is probably because marginally more daugter cells are produced by the basal layer, and produced more quickly. The effect is that the spiny layer and the dranular layer thicken up. The speed at which cells are replaced slows down, and some of the function of skin, including controlling water loss, may become less efficient. There is less elasticity and increased fragility. Skin becomes dry, flaky and less reflective of light.

As photoageing begins, the small blood capillaries in the dermis decrease in number and the remaining blood vessels become tortous and dilated. The elastic fibres degenerate, producing a thickened mass that replaces the collagen. Seriously photoaged skin is dry, deeply wrinkled, yellow and rough. It may be marked with darkly pigmented or whitish spots, which respectively show where levels of pigment are higher or lower than normal. With increasing sun damage small blood vessels in the dermis will become more obvious and will form the red, finely branching, spider-like marks (“broken veins”).

These blood vessels are easily damaged, resulting in greater fragility of the skin, with the development of spots. Loss of elastic fibres around the blood vessels of the lower lips and ears – areas especially sensitive to chronic sun damage – may result in dilated veins. On the other hand, in protected skin the vessels tend not to be so dilated or damaged. As its worst, skin that has been over-exposed to the sun for many years looks like old leather. Constant exposure to UV light over many years can result in warty spots on the skin, called actinic keratoses.

The appearance of actinic keratoses means that the skin has received far too much sun and could develop a skin cancer eventually. (4) There are three main types of cancer: Basal cell carcinoma is the most common form of skin cancer. The skin is formed of three layers. The deepest, the subcutaneous layer, is composed of fat and connective tissue and connects the skin to the underlying muscle. Above that is the dermis, the layer that containssweat glands, oil glands, and other structures of the skin. The third layer, on the surface is called the epidermis; it is there that most skin cancers arise.

Basal cell carcinomas arise in the lowest of the epidermis, the basal cell layer. This type of cancer can have many different appearances: a red patch or irritated area; a small, pink pearly bump, a white or yellow scar-like area; a smooth growth with a dent in the center, or an open sore that bleeds or oozes. Basal cell carcinomas rarely spread throughout the body and death from them very rare; however, because they often occur on the face, their locally destructive effects can result in serious cosmetic deformity if not diagnosed and treated early.

Squamous cell carcinoma arise from the upper levels of the epidermis, usually on places that have been exposed to the sun. Squamous cell carcinomas are most commonly found on the ears, the face, and the mouth. This type of skin cancer often arises from a precancerous lesion known as an actinic keratosis, a type of lesion that appears as a rough, flat pink spot. If the lesion becomes cancerous, it’s usually raised above the normal skin surface and is firmer to the touch. Squamous cell tumour tend to be more aggresive than basal cell tumours, and are slightly more likely to spread to other parts of the body.

Melanoma, the most serious form of cancer, is not as common as the other two major types of skin cancer (basal cell and squamous cell cardinomas). Melanoma begins in melanocytes, the cells in the epidermal layer of the skin that produce the pigment melanin. Melanin in normal melanocytes produces “tan” skin as a response to damage from UV light. Melanoma can arise by several routes. Sometimes it arises directly from a melanocyte. Sometimes, the melanocyte first turns into a normal mole or irregular mole, and then becomes cancerous. Melanocytes can also be found in the eye and internal organs, where they also become cancerous on occasion.

Melanomas are cancerous, but the large majority do not spread right away. Many begins as a “melanoma in situ”. During that stage, the growth does not venture beyond the very most superficial layer of skin, the epidermis. In a second stage, melanoma can penetrate the lower layer of the skin, the dermis. If the melanoma penetrates very deeply into the dermis, it may progress to a vertical growth phase – in which it can metastasize, or spread throughout body. Melanoma more often shows up on the trunk of the body and on the arms and legs, it can develop on any part of the body – including those never exposed to the sun. 14)

A large proportion of skin cancers can be prevented and, if not prevented, they are curable if recognised and treated when at early stage of development. UV can also damage the surface of the eye, called the cornea, and cause cataracts, macular degeneration, scarring on the cornea and skin cancer of the eyelids and area around the eye. UVB can cause a sunburn on the cornea, the clear membrane that covers the front of your eyes. Corneal sunburn, called photokerastitis, can occur after long hours at the beach or on the ski slopes without sunglasses or goggles.

It is not permanent, but it can be painful and cause temporary vision loss. Sun damage can also cause scars on the surface of the eye, called pinquecula, which are raised, yellowish, benings lumps that grow near the nose. These can be removed wity surgery. (8) More serious effects of UV are cataracts and macular degeneration. Cataracts – the clouding of the lens of the eye, the number one cause of reversible blindness – and macular degeneration are the leading causes of decreased vision among people older then 60. Cataracts can be treated with surgery.

The UV damage to the eye is cumulative and much of it is preventable by wearing quality sunglasses or contact lenses to make sure they block UV light. They are a sunscreen for our eyes. (10) All people regardless of skin pigmentation, are susceptible to damage to their immune system as a result of UV light. The absorbtion of UV light leads to immunosuppresion. As UV light are absorbed by a human being, there is a decreased immune response. This reaction is favourable because there is no excessive swelling and damage to the skin as result of sun exposure.

The drawback of decreased immune response is that when infection diseases do attack the body, a significant forceful immune reaction is needed. As a result, cancer often developes and spreads in the body because the immune systems has not the strenght to fight it due its suppresion by damage UV light. Other immune system damage is seen in the form of skin hypersensitivity and reactions to certain medications. UV light is very dangerous to the human immune system and should be avoided to prevent cancer and other infectious, life-threatening diseases. (16)

Cold injuries result from overxposure to cold air or water and occur in two major forms: localised injuries (such as frostbite) and systemic injuries (such as hypothermia). (4) The risk of serious cold injuries, especially hyporthermia, is increased by youth, lack of insulating body fat, wet or inadequate clothing, old age, drug abuse, cardiac disease, smoking, fatigue, hunger and depletion of caloric reserves, and excessive alcohol intake (which draws blood into capilaries and away from body organs). (1) Frostbite is a medical condition that can happen to anyone.

It is when the skin and/or tissue under the skin freezes and causes cell damage. This is caused by exposure to cold, either through the air or through a chemical exposure. When people are exposed to cold with the extremities including their feet, hands, nose, ears, and face being at the highest risk, the blood vessels constrict. This is a natural reaction to prevent body heat loss and hyporthermia. With the loss of warming blood flow the fluid within cells and tissues start to freeze forming ice crystals. These ice crystals take up more room within the cells then when in a fluid state, and cause the cells to rupture.

Also, sudden warming can cause the cells rupture. Under extreme conditions frostbite can occur in seconds. Factors like wind chill, alcohol consumption, getting wet or being damp and how long you are exposed to the cold all impact how quickly and how severe frostbite can be. The elderly, young children, people with circulation disorders, and people from tropical climates have a higher risk factor of getting frostbite. People who have had previous cold injuries are also particularly at risk of getting injuries again in the same places.

Frostbite comes in three levels of severity or degrees: *First degree, also called frost nip. It presents itself as numbed skin that has turned white in colour. The skin may feel stiff to the touch, but the tissue under is still warm and soft. There is very little chance of blistering, infection or permanent scarring as long as it is treated properly. *Second degree, superficial frostbite. It is a serious medical condition that needs to be treated by a trained medical professional. The skin will be white or blue and will feel hard or frozen.

The tissue underneath is still undamaged. Blistering is likely which is why medical treatment should be sought out. Proper treatment is critical to prevent severe or permanent injuries. *Third degree, deep frostbite. The skin is white, blotchy and/or blue. The tissue underneath is hard and cold to the touch. This is a life threatening injury. Deep frostbite needs to be treated by a trained medical professional. The tissue underneath has been damaged, in severe cases amputation may be the final resource to prevent severe infection.

Blistering will happen. Proper medical treatment in a medical facility with personnel trained to deal with severe frostbite injuries is required to aid in the prevention of severe or permanent injury. (9) Prevention of frostbite is actually very simple and for the most part is based on common sense. Hypothermia is heat loss at the body core, and it results from exposure to cold with the addition of other heat loss mechanisms. A healthy person’s body temperature can fluctuate between 36. 1 degrees and 37. 8 degrees.

Hypothermia is considered to begin once the body temperature reaches 35 degrees, thought even smaller drops in temperature can have an adverse effects. Hypothermia is divided into two types: primary and secondary. Primary hypothermia occurs when the body’s heat-balancing mechanisms are working properly but are subjected to extreme cold, whereas secondary hypothermia affects people whose heat-balancing mechanisms are impaired in some way and cannot respond adequtely to moderate or perhaps even mild cold. Primary hypothermia typically involves exposure to cold air or immension in cold water.

The cold air variety usually takes at least several hours to develop, but immersion hyporthermia will occur within about an hour of entering the water, since water draws heat away from the body much faster than air does. In secondary hyporthermia, the body’s heat-balancing mechanisms can fail for any numbers of reasons, including strokes, diabetes, malnutrition, bacterial infection, thyroid disease, spinal cord injuries, and the use of medications and other substances that affect the brain or spinal cord. Alcohol is one such substance.

In smaller amounts it can put people at risk by interfering with their ability to recognize and avoid cold-weather dangers. In larger amounts it shuts the body’s heat-balancing mechanisms. Secondary hypothermia is often a threat to the elderly, who may be on medications or suffering from illnesses that affect their ability to conserve heat. Malnutrition and immobility can also put the elderly at risk. (12) The signs and symptomps of hypothermia follow a typical course, thought the body temperatures at which they occur vary from person to person depending on age, health, and other factors.

The impact of hypothermia on the nervous system often becomes apparent quite early. Coordination may begin to suffer as soon as body temperature reaches 35 degrees. The early signs of hypothermia also include cold and pale skin and intensive shivering; the latter stops between 32. 2 and 30 degrees. As body temperature continues to fall, speech becomes slurred, the muscles go rigid, and the victim becomes disoriented and experiences eyesight problems. Other harmful consequences include dehydration as well as liver and kidney failure.

Heart rate, respiratory rate, and blood pressure rise during the first stages of hypothermia, but fall once the 32. 2 degrees mark is passed. Below 30 degrees most victims are comatose, and below 27. 8 degrees the heart’s rhythm becomes dangerously disordered. Yet even at very low body temperatures, people can survive for several hours and be succesfully revived, thought they may be appear to be dead. (12) People who spend time outdoors in cold weather can reduce heat loss by wearing their clothing loosely and in layers and by keepimg their hands, feet, and head well covered.

Because water draws heat away from the body so easily, staying dry is important. Alcohol should be avoided because it promotes heat loss by expanding the blood vessels that carry body blood to the skin. Alcohol consumption, exposure to ultra violet light and cold injurys have harmful effects on our body and its defence mechanisms. It affects virtually all areas of a person’s life; socially, psychologically, physiologically and mentally. It can be easily avoided by using just a little common sense.

Osteoporosis is a disease that is described by low bone mass and loss of bone tissue basically thinning of the bones that lead to weak and fragile bones. Bones are always in a state of changing where new bone tissues are replacing the old bone tissue in order to keep the strength. It affects men and women but it is usually a disease that affects mostly women. However, when someone is diagnosed with osteoporosis it means that the bone tissue and mass are not replaced as fast with new bone tissue which is one factor of osteoporosis. Another factor that causes osteoporosis is a deficiency in estrogen which typically occurs in menopause causing low bone density because of the drop of estrogen. The probable effects on the everyday life of an 84- year old thin white female may be critical. Since the bones become so thin and have low bone density, a minor fall can cause a fracture. Osteoarthritis Of all bone deficiencies osteoarthritis is the most common.

It typically comes with aging and wearing of the joints. The joints have protective cartilage(cushion that separates the joint from the bone) on the end of your bones that once you get older wear down damaging the joints. It affects both men and women. Generally, before the age of 45, it affects men and affects women normally after the age of 55. The causes of osteoarthritis are not due to injury or wear and tear of the joint although can have an increase in the severity but mostly has to do with the natural aging of the joint. It mostly affects the hands, feet, knees, and hips. In an 84-year-old thin white female osteoarthritis can be painful. Stiffness is a symptom of osteoarthritis which causes pain after the inactivity of the joint after a period of time. Muscular Atrophy Muscular atrophy unlike the other diseases I’ve mentioned is specifically targeted at the muscles. It is a disorder that causes progressive deterioration and weakness of the muscles. There are different types of muscular atrophy. There are 3 types that affect children before they turn 1.

The most severe of them all occurs before birth, around 30-36 weeks of pregnancy which is called Type 0. The other two types I and II which affect that child at birth or around the first few months. In adults, there are two types. Those types are the Finkel type and Type IV which usually affect adults after age 30. Muscular atrophy occurs generally with age, however, it can also be caused by injury, birth defects, stroke. Spinal cord injury and sometimes can occur due to osteoarthritis. An 84- year old white, thin small boned white female with muscular atrophy can have back pain, walking problems, and limited range of motion which are some of the many symptoms of the disease.

References

1. What is osteoporosis and can it be treated? (2011, Nov 09). Liverpool Echo, pp. 22. http://search.proquest. com/docview/902777135? accountid=27655
2. What causes osteoporosis?. (2010). Osteoporosis: A Guide to Prevention & Treatment (2010).
3. What you should know about osteoarthritis. (2012).
4. American Family Physician, 85(1), 57-58 4. Ask dr. H: What causes osteoarthritis? (2012, Feb 27). Press of Atlantic City, pp. n/a. http://search.proquest.com/docview/923715946? accountid=27655
5. “Spinal muscular atrophy” A Dictionary of Biomedicine. Oxford University Press Inc. Oxford Reference Online. Oxford University Press. ITT Educational Services. 27 April 2012
6. http://www.oxfordreference.com/views/ENTRY.html? subview=Main&entry=t312.e8720>
7. Spinal muscular atrophy: What it is and how to cope. (2008, ).
8. http://search.proquest.com/docview/390101328? accountid=27655

An Analogy of a plan cell to a country nucleus/governement/primie minister/parliament house- they are the control centre of the city or cell. They both control what goes on in the city or cell. the nucleus contains all the DNA or important information, of the whole cell. it is the control centre and it gives out orders that the cells have to carry out. the president in a country know it’s important information, he gives out laws that have to be carried out by the people and leads the country mitochondria-power plant- this is the ‘powerhouse’ of the cell or city.

The mitochondria and the power plant both provide the energy for the city or cell to use. mitochondria breaks down and convert them to energy for cells. power plant generate and supply energy for the country. Cell Membrane/national security, military, Border Security- the Cell membrane or police/ Border Security controls entry of what goes in and out of the cell or city Vacuole/ Stores/warehouses+ water treatment plant + Garbage dump- a vacuole can contain many different types of fluids in it and it also has many different functions.

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The vacuole can be a storage room which contain fluids and material solutions like plant pigments. It has can also be a garbage dump which contains its wastes. Furthermore the vacuole can be a water tower which stores water in it. vacuoles store materials for the cell. stores around the country. it stores necessay materials such as food and clothes for people Ribosomes/ Food producing factory (protein factory)- the ribosomes and food producing factory are both where the production of proteins occur. ribosomes produce protein from information from the dna given by the nucleus. restuarnts cook and give out food that contain protein

Endoplasmic Reticulum/ highways, roads and vehicles traveling them- the transport of substances within cells or cities occur through these. it assembles materials and export them from the cell. companies that trade and export materials from the country also may package and prepare them to be sent of . Golgi Apparatus/ Food Packaging Company- the Golgi Apparatus and Food Packaging Company both package materials for export. Chloroplasts/ Solar power panels- the chloroplast and the solar power panels both can capture the radiant energy of sunlight and transform it into useable energy.

Alcohol is the most abused drug in most countries. The consumption of alcohol is more intense than any other drug due to its availability, and the laws governing its consumption which does not prohibit its consumption unlike other drugs, for example, hard narcotic drugs such as Marijuana.

Although the law of different countries restrict the drinking age, which is 18 years and 21 years in some states, there is increased consumption of alcohol among the young people below the recommended age.

The effects of alcohol are numerous and vary with the amount of alcohol consumed as well as the personal characteristics such as body weight, nutrition status, age, period of consumption and gender among others. This paper aims at analyzing the various effects in a human body attributing from alcohol consumption.

Alcohol leads to deposition of fatty plaques in the inner walls of the arteries hence they become narrowed, as a result blood supply becomes insufficient. The insufficiency of blood in the brain leads to stroke while into the heart leads to heart attack.

However, evidence in recent research has shown that alcohol may lower heart diseases’ risks. According to the research, the consumption of one to two standard drinks of alcohol per day in middle-aged and above (35 years and over), offers some protection against heart disease. (Glen et al, 2005)

Brain

Alcohol causes damage to the brain cells which leads to memory loss; an individual becomes confused and suffers hallucinations. Alcohol is regarded as a downer due to its direct effects on the brain cells. The damage can be fatal or lead to insanity if alcohol is taken in large amounts or taken along with other hard drugs such as narcotics over a long period of time.

Alcohol cuts the supply of oxygen to the brain, a situation which kills thousands of brain cells each time a person takes alcohol. This may lead to hyper alertness to normal situations such as perceiving sound to be louder than normal or light too bright than in the real situation (that is augmentation).The drinker may develop alcohol influenced behavior (learned behavior syndrome) which  stops after the person quits drinking and it can only be re-learnt

The Central Nervous System (Cns)

The brain, spinal cord and nerves originating from it form the Central nervous system. The transmission of sensory impulses and motor impulses pass from the CNS. Alcohol affects the CNS leading to intoxication hence affecting emotional and sensory function, memory, judgment as well as decreased learning capabilities.

The smell and tenses are impaired and the ability to withstand pain increases with increase in Blood Alcohol Level (BAL). The long term effects of consumption of alcohol on the CNS causes tolerance, dependency and brain irreversible damages. The functioning of the nervous system deteriorates in every drinking episode that leads to intellectual dysfunction; disturbances in the sensory and motor control follow. (Haven and Gerald, 1996 pp. 198-256)

Blood

Alcohol causes blood sludging, a situation whereby the red blood cells bunch together causing the small blood vessels to block up, starve the tissues of oxygen causing the death of cells. In the brain this death of cells is more severe and often goes unnoticed. Due to increased pressure, the capillaries break, leading to red eyes in the morning, or the red, blotchy skin which appears on the face of a heavy drinker.

Hemorrhage or death may occur when Blood vessels break in the stomach and esophagus. on the blood can also cause anemia, sedation of the bone marrow (this reduces the white and red blood count, and weaken the bone structure lowering the body’s resistance to infection. (Raymond et al. 1996 pp. 43-213)

Introduction

The tissue shows vast inflammation, there are large gaps in between the hepatocytes due to cell necrosis and the hepatocytes remaining are large and swollen. There are fatty deposits throughout the tissue and fibrous structures present which are most likely collagen. The hepatocytes themselves are not only swollen but have the presence of globular material within. This is identified as Mallory bodies, seen in cases of alcoholic hepatitis. These globules are aggregates of intermediate filaments in the cytoplasm which have resulted from hepatocyte injury. Neutrophils can be seen in the sample which is the likely cause of inflammation. These would have been called to the tissue due to the necrosis of the hepatocytes and the presence of cellular debris within the lobules [1]. An infiltration of macrophages can be seen which would also be due to the debris present.

The first stage of alcoholic liver disease is the increase of fatty deposits in the liver. Heavy alcohol consumption causes the production of large fatty globules a process known as macrovesicular steatosis collecting in the liver cells. Ethanol consumed is metabolised by alcohol dehydrase in the mitochondria into toxic acetaldehyde which is metabolised by aldehyde dehydrogenase into acetic acid [1][2][3]. The production of acetaldehyde causes a higher NADH: NAD ratio which is the main mechanism in the development of this condition. This NADH production causes increase in lipogenesis and a decrease in fatty acid oxidation. The higher levels of fatty acids signal the hepatocytes to compound glycerol into triglycerides [3]. This is seen in the first stage of liver damage known as alcoholic hepatitis [2]. Excess alcohol intake can also cause hepatocyte injury via oxidative stress from increased NADH production in which free radicals damage the hepatocytes (increased production by the kupffer cells); and from lipid peroxidation where acetylhyde binds to proteins forming adducts [1]. This binding triggers humoral and cellular immune responses resulting in tissue injury. There is an increase in pro inflammatory cytokines such as tumour necrosis factor and interleukin -6 and a decrease in anti inflammatory cytokines such as interleukin -4 [1]. These cytokines in particularly TNF are secreted by the kupffer cells (macrophages) located in the liver. They’re activated by the increased levels of endotoxin released from the breakdown of alcohol by intestinal bacteria; this binds to the CD14 receptor on their surface initiating response. The release of these cytokines leads to the hepatic stellate cells producing increased levels of collagen which leads to liver fibrosis and also causes destructive damage to the hepatocytes. This leads to the last stage of liver disease known as cirrhosis which can occur in prolonged alcoholic hepatitis, seen in 40% of cases [1][4].

Individuals suffering with alcoholic hepatitis have an increase in serum bilirubin due to the inability of the damaged liver to process it. Bilirubin is normally removed from the blood by the liver, processed by it and released into the bile [4][5]. They’ll also have prolonged prothrombin time which reflects decreased hepatic synthetic function [4][5]. A number of clotting factor proteins are produced in the liver so an increase in coagulation time suggests a decrease in these factors indicating dysfunction of the liver. Decreased serum albumin can be observed in cases of liver injury as this is the main protein produced in the liver. Thyroid tests can indicate liver dysfunction such as testing for T3- triiodothrynonine which appears decreased in individuals with alcoholic hepatitis and is proportional to the level of damage[6][4]. There is also a decrease in serum cholesterol level seen in this condition.

In cases where excessive alcohol consumption is not the cause of hepatitis further testing should be done. Individuals can develop hepatitis due to drug use as currently 1000 drugs are seen to be hepatotoxic [7]. There must be a chronic correlation seen between when the medicine was first taken and the observation of hepatitis. There must also be a correlation between the removal of medication and the recession of the condition [4].

Other causes of hepatitis must also be tested for such as viral hepatitis. There are 5 subsets of viral hepatitis A, B, C, and the less common D and E forms. Hepatitis A is the most common form and is passed on by the faecal– oral route. It’s tested for by the presence of the anti-HAV IgM antibody which tests positive before the development of clinical hepatitis and remains positive for at least 4months. Hepatitis B is tested for by the presence of surface antigen HBsAg. Anti HBC total and Anti – HBC IgM is also tested for. A soluble protein HBeAg is produced by the virus in acute and early chronic stages of hepatitis B so positivity of this indicates infection. Hepatitis C infection has the presentation of Anti-HCV seen in 90% of individuals with this infection [7].

The possibility of autoimmune hepatitis can be ruled out by testing of HLA class II expression on the surface of the hepatocytes. There is also an increase seen in IgG antibody and a variety of other antibodies such as SLA/LP (anti soluble liver protein) [8].

References

[1] Hopkins. J. Alcoholic liver disease – Introduction, gastroenterology and hepatology. Baltimore M.D 2010

[2] www.britishlivertrust.org . Accessed 28.11.10

[3 ]Drriad. Pathogenesis of hepatitis infection from chronic alcoholism, Figure 1. 2007

[4] www.hepatitis.org. Phillipe.L, Hepatogastroenterology department, Brugmann University Hospital Brussells Accessed 28.11.10

[5]http://www.gastro.com/Gastro/liverdisease/liver_function.aspx, Gardner. P.W and Waldstreicher.W, American Liver Foundation 1995 Accessed 28.11.10

[6] Borzio. M et al, Thyroid function tests in chronic liver disease: evidence for multiple abnormalities despite clinical euthyroidism. GUT Journal of gastroenterology and hepatology, Vol 24(7), Jul 1983. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420033/. Accessed 28/11/10

[7] http://www.oaml.com/PDF/CLP012.pdf. Guidelines for clinical laboratory practice, revised March 2000, Accessed 28.11.10

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