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Latest News - page 2
Replacement Turret for Lufeng FSO Completed
SOFEC said it has loaded out of the replacement turret for the floating storage and offloading unit (FSO) HYSY121 at the Lufeng field, in the South China Sea.The construction was completed at Penglai Jutal Offshore Engineering Heavy Industries Co…
Indonesia Plans New Gas Pricing for Industrial Users
Indonesia plans to unveil a new gas pricing policy for industrial customers in March in a bid to lower energy costs for manufacturers, Energy and Mineral Resources Minister Arifin Tasrif said on Thursday.Indonesia's President Joko Widodo earlier…
For the first time, China will this year allow foreign companies to explore for and produce oil and gas in the country, opening up the industry to firms other than state-run energy giants, as Beijing looks to boost domestic energy supplies.The…
Mammoet Completes ALE Acquisition
The Netherlands-based Mammoet confirmed it has completed its acquisition of UK-based rival ALE, creating the industry's largest engineered heavy lifting and transport services provider.The businesses will operate as one company under the Mammoet…
Oil Hits $70 a Barrel
Oil prices rose a further 2% on Monday, pushing Brent above $70 a barrel, as rhetoric from the United States, Iran and Iraq fanned tensions in the Middle East after a U.S. air strike which killed a top Iranian military commander.Brent crude futures soared to a high of $70…
Asian LNG Prices Little Changed in Quiet Trade
Asian spot prices for liquefied natural gas (LNG) were little changed this week amid quiet trade and low liquidity.The average LNG price for February delivery into northeast Asia was estimated at around $5.10-$5.20 per million British thermal units (mmBtu)…
Petrochemicals: Weak Margins Sweep Asia
Asian petrochemical makers, who are unable to pass down sky-high feedstock costs, are resorting to run cuts or extending cracker shutdown periods to tie through the bad times.The gloom was evident across South Korea, Asia's top naphtha importer…
Anchor-handling tug supply (AHTS) vessel ENA Shogun will commence a one-year project (+options to proceed further) with a Bruneian oil company, primarily supporting semi-submersible rigs in their fleet.VOS Singapore said it has secured a third…
Sapura Esperanza Extended in Malaysia
Oil and gas services firm Sapura Energy said it has been awarded a contract extension by Sarawak Shell Berhad / Sabah Shell Petroleum Company Limited, for the provision of a semi-submersible tender assist drilling rig, Sapura Esperanza.The contract…
Oil rose on the last trading day of the decade on Tuesday and was on track for monthly and annual gains, supported by a thaw in the prolonged U.S.-China trade row and Middle East unrest.Brent crude was up 11 cents at $66.78 a barrel by 1143 GMT…
Danish wind turbines manufacturer Vestas Wind Systems A/S has received a 55 MW order in China that includes supply of 25 V120-2.2 MW wind turbines as well as a 2-year Active Output Management 4000 (AOM 4000) service agreement.Deliveries are expected to begin in the second quarter of 2020…
Puma Energy Sells Fuels Business to Chevron Australia
Singapore's Puma Energy, the retail and midstream arm of global commodities trader Trafigura, said on Thursday it would sell its Australian commercial and retail fuels business to Chevron Australia for A$425 million ($288 million).Puma Energy is 49%-owned by Geneva-based Trafigura…
Oil Hits Highest Since September
Oil rose towards $68 a barrel to its highest in over three months on Thursday, buoyed by a report showing lower U.S. crude inventories, hopes of an end to the China-U.S. trade dispute and OPEC-led efforts to constrain supply.The American Petroleum Institute…
China's Longest Ethane Pipeline Starts Operation
China National Petroleum Corp (CNPC) said its Xinjiang oilfield unit has delivered 500,000 cubic meters of ethane after being put into operation a week ago, the company stated on its website on Wednesday.Construction work on the 371 kilometer-long pipeline…
China's Wind Repowering Market to Boom from 2023
State-owned enterprises to dominate wind repowering marketChina's wind repowering market is expected to take off from 2023, finds a new report by Wood Mackenzie. More than 21 gigawatts (GW) (cumulative capacity) of China's wind turbine fleet…


On behalf of Mahaffey & Associates, LLC posted in Divorce on Wednesday, March 14, 2018.
It's hard to know what to do when someone you care about is going through a divorce. You may want to help -- but at the same time be afraid of saying or doing the wrong thing at the wrong time.
This is actually tricky because "support" often gets confused with "agreement."
Support means telling your friend that he or she is strong and able to get through this period of life. It does not mean agreeing with your friend's assessment of his or her spouse.
In fact, it's dangerous to jump on your friend's bandwagon at the moment and reveal that you always hated his or her choice of a mate the moment the divorce is announced. Your friend's mood may shift abruptly and he or she could try to reconcile. If that happens, your friend may feel like you are judging him or her.
One of the hardest things your divorcing chum has to handle is being a "single" again when he or she is used to automatically having a partner.
Open your heart and your door and make sure that your friend is invited along with you wherever you're going. Don't worry if he or she is going to be the only single person among a crowd of couples -- that matters a lot less than being set adrift by the people that you know.
If your friend needs someone to listen, listen. Don't talk about your own marital problems or divorce. Let your friend get out what he or she needs to get out right now. There will be time to compare notes later. Also, if your friend needs to just exist in companionable silence, let him or her do so. Your friend will start talking when he or she is ready.
Divorce has a way of making everyone feel uncomfortable -- but remember that your friend is probably feeling the worst right now. Anything you can do to show your unconditional love for your friend will help.


October is National Depression Awareness Month as well as LGBTQ History Month. Both are extraordinary causes that deserve attention, awareness, and celebration. For my family and me, they are intertwined and deeply personal.
When our son came out to us in February 2017, he was 16 years old. While my husband and I were blindsided, we quickly snapped out of our shock and jumped into learning as much as we could and supporting him in every way possible. We learned that he had known since he was 13 that he felt "different." We learned that the anxiety that we thought at the time was sports-related was really him trying to mask his true identity. We learned that our son, the oldest of four, the high-achiever and ever the rule follower and pleaser, was absolutely brilliant at living two lives.
Between February and October 2017, unbeknownst to us at the time, the stakes raised in this duality causing his anxiety to skyrocket and depression to deepen. Following a major jaw surgery and significant weight loss, we realized the therapy he was receiving was barely scratching the surface. While maintaining good grades at school, he began to spiral: self-harming, smoking pot, drinking, and vaping to ease the pain and intensity of his inner struggle. He was disappearing before our eyes, tortured and filled with self-loathing. Terrified and wrought with worry, we naively thought we could love and support him enough to rescue him from his desperate hell. We quickly realized, however, that we needed professional guidance.
Surviving a suicide attempt, we took him to an intensive residential therapeutic program in California two days later.
Because I know our story is not unique. Because I know my family is not the only one who struggles with depression and anxiety. Because I'm tired of everyone putting up a facade. Because it's time to have authentic conversations about depression and support one another. And, it's why I've started Chrysalis Mama, an online platform for support, discussion, and resources.
I doubt it is a coincidence that LGBTQ History Month and Depression Awareness Month coincide. According to the National Alliance on Mental Illness, LGBTQ individuals are three times more likely to struggle with mental health issues, and more alarmingly, LGBTQ youth are four times more likely to experience suicidal ideation, attempt suicide, and engage in self-harm. These are staggering numbers, ones that my family knows to be true.
The official site for LGBTQ History Month provides a fascinating education. It makes my heart sing to learn about and celebrate all of those brave souls who came out long before my son who have fought so hard for recognition and equality.
Get Help. If you suspect or know for a fact that your child or a loved one is struggling with depression, help is available! It's OK to ask! Please do not be embarrassed or worry what others may think. The health and well being of your child trumps all social nonsense. Anxiety and Depression Association of America as well as the National Alliance on Mental Illness are terrific online resources filled with helpful tips, hotlines, and a ton of research studies. Haven Youth and Family Services is a local resource that I truly cannot say enough good things about. They understand mental illness, and they understand how our children and teenagers are growing up today and what it is like to be a parent today. They also have a terrific understanding of the LGBTQ community and are an invaluable resource, with both group and one-on-one support options.
Remember that we all struggle. Be gentle with yourself and with others. My sister-in-law recently sent me a T-shirt that says "We all Struggle. Choose Kindness." These shirts support the foundation her friend started that promotes random acts of kindness in honor of her brother, whom she lost to suicide. It is a reminder never to underestimate the power of a smile or kind word.
Be grateful. Not too long after our son left for California, a friend introduced me to The Secret. It is basically the study of the Law of Attraction: Ask, Believe, and Receive. You may be skeptical, as I was at first, but I am here to tell you it works. Every day he was away, I focused on what I was grateful for that day and visualized him coming home healthy and fulfilled — essentially being grateful for what I wanted for the future. Gratitude is a great practice to center yourself, interrupt anxiety, and focus on what is important. Celebrate the little things to keep positive!
Don't give up. When your child or loved one is struggling with depression it is easy to get overwhelmed and filled with fear. The answers often aren't obvious. It is natural to feel exasperated and to want to give up. Don't. When a roadblock is thrown your way, pivot. I promise the solution is out there and there are people who are eager to help! In addition to the resources I've already mentioned, an Educational Consultant can really help you figure out the best options for your child.
Embracing vulnerability and gratitude, our son has returned healthy, has transitioned well into his senior year, and is filled with self-acceptance and self-love. We are fully aware that our outcome is uncommon; and it is our hope that this article encourages any in need to reach for help. It is there.
Haven Youth and Family Services invites LGBTQ youth and Allies ages 13-18 to a weekly drop-in and support group on Thursdays from 7-8 p.m. The informal gathering provides a safe, inclusive, and affirming space to foster relationships, build self-confidence, and explore thoughts or questions regarding sexual orientation or gender identity. Please contact Kate Versage at [email protected] with questions or call 847-251-6630 to speak to any staff member.
Heather Hester is a professional writer who creates captivating content and newsletters for her clients. She is passionate about having authentic conversations about mental health, and supporting and advocating for all LGBTQ+. She lives with her hilarious husband, four incredible children, and one high-strung dog. Join the conversation at chrysalismama.com or follow her on Twitter @chrysalismama1.


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Production Planner 3 - Military Veterans
at Northrop Grumman
At the heart of Defining Possible is our commitment to missions. In rapidly changing global security environments, Northrop Grumman brings informed insights and software-secure technology to enable strategic planning. We're looking for innovators who can help us keep building on our wide portfolio of secure, affordable, integrated, and multi-domain systems and technologies that fuel those missions. By joining in our shared mission, we'll support yours of expanding your personal network and developing skills, whether you are new to the field or an industry thought-leader. At Northrop Grumman, you'll have the resources, support, and team to do some of the best work of your career.
Northrop Grumman manufactures some of the world's most technically advanced products. Our manufacturing plants are highly-automated, cutting-edge centers of excellence where employees leverage the latest technology, including the strategic use of automation, 3-D printing and robotics. There are a myriad of job functions associated with the manufacture of our products that range from machinists, engineers, operation program managers, and quality inspectors. Our mission is to deliver differentiated value to our programs, by manufacturing products with the highest possible quality at the most affordable rate. Search our current job openings and join us to be at the front line of innovation.
The Salt Lake City Configuration Data team at Northrop Grumman Mission Systems (NGMS) is looking for you to join our team as a Production Planner 3 based out of Salt Lake City, UT.
What you'll get to do:
•	Use SAP/MRP/PDM systems and interpret detailed engineering drawings, manufacturing bills of materials, and related engineering documentation (e.g. engineering changes, parts lists and drawings) to create and update AssemblyInstructions (A.I.) and other related manufacturing documents.
•	Work with manufacturing, quality, and test engineering on processes and A.I. maintenance
•	High School diploma or equivalent and 4 years additional education and/or related experience
•	Experience reading and interpreting engineering drawings and parts lists.
•	Experience working in Excel, PowerPoint, and Word.
•	Strong written and verbal communication skills.
•	Associates Degree or 2+ years into undergraduate degree program.
•	4 Years related experience.
•	Experience working in Broadvision's Quicksilver or other document management software.
•	Working knowledge of SAP.
Northrop Grumman is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. For our complete EEO/AA and Pay Transparency statement, please visit www.northropgrumman.com/EEO. U.S. Citizenship is required for most positions.
Become part of a team at the forefront of technology and the frontline of defense when you start Defining Possible with Northrop Grumman. We currently have opportunities across the world for those ready to solve our toughest challenges on land, sea, air, space and cyberspace.
With Northrop Grumman, you'll be joining a culture where your voice is heard and contributions are valued. Launch your career and join the over 17,000 veterans pushing past possible every day to create and deliver the most advanced systems that connect and protect our world.  Northrop Grumman careers and internships are as varied as your interests, with a lifetime of potential that will allow you to work together with people from many backgrounds, personal passions and disciplines.
© 2020 Northrop Grumman is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. U.S. Citizenship is required for most positions. For our complete EEO/AA and Pay Transparency statement, please visit www.northropgrumman.com/EEO.
Website: http://careers.northropgrumman.com
Configuration Controller 2
Northrop Grumman | Salt Lake City, Utah
Manager General Manufacturing 2 (2nd shift)
Precision Electromechanical Assembler 2
Mgr Mission Assurance 3
Manager Engineering 2
Mgr Quality Engineering 2
Intern Manufacturing
Principal Propulsion Design Engineer
Northrop Grumman | Magna, Utah
Intern, Information Technology
Northrop Grumman | Roy, Utah
Sr. Principal Propulsion Design Engineer

redpajama_set_name: RedPajamaCommonCrawl


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The National Anthem of Pakistan
The National Anthem Music in contemporary form
Other Patriotic Songs
Founder of Pakistan
Quaid-e-Azam
Pakistan My Pride My Passion
Pakistan Portal
Pak Saudi Relations
Tourism & Education
Education in Pakistan
Education in Pakistan in a Glance
Top Universities of Pakistan
Tourism in Pakistan in a Glance
Tourism Top Websites
Machine Readable Passport
Manual Passport
Attestation of Documents
Passport Fee
Online Advance Token (MRP)
NADRA
Track NOC Form
Grievance Commissioner Cell
Welfare Wing
Commercial Wing
Pak Saudi Bilateral Trade
Sauid Arabia
Trade & Investment opportunities in Pakistan
Pakistani Companies in KSA
Pakistani Exporters
Saudi Importers sector wise
Trade Diplomacy
Joint Ministerial Commission
Doing business with KSA
Doing business with Pakistan
Research/ Product Reports
Report on Kinnows
Report on Rice
Employment Opportunities for Pakistani Nation
Details of Job Vacancies
1. The Embassy of Pakistan invites applications for eight posts of Consular Assistant, four posts of Data Entry Operator and eight post of Messenger-cum-Security Guard. Details for the posts are as follows:
2.	Minimum qualification for Consular Assistant and Data Entry Operator is graduation while for Messenger-cum-Security Guard is matriculation. Candidates with higher education/additional certificates will be given preference.
3.	Candidates must have a valid and transferrable resident/work permit.
4.	The post of Consular Assistant and Data Entry Operator (DEO) are temporary and will be renewed on annual basis subject to performance. The total emoluments (including all benefits) for Consular Assistant & DEO is SAR.3,450/- and SAR.2,875/- Messenger-cum-Security Guard.
5.	Candidates who can speak and write Arabic will be preferred.
6.	All candidates would be required to undergo a written test, followed by an interview.
7.	Typing speed of 30 wpm or more is mandatory for Data Entry Operator and Consular Assistant. Separate test for typing will be held to check the eligibility.
8.	All candidates, while forwarding their CVs, must clearly specify the position for which they are applying.
9.	Interested candidates are requested to send their CVs (as per format given below) via e-mail to parepriyadh@mofa.gov.pk or through mail to Head of Chancery, Embassy of Pakistan, Diplomatic Quarters, P.O Box #.94007, Riyadh
10. The applications must be received within 15 days of the date of advertisement.
11. Format of BIO Data
Post applied for : _____________________
Name : _____________________
Father's Name	: _____________________
Iqma No.	: _____________________
Pakistani CNIC No. or
Passport No.	:
Nationality	: _____________________
Age : _____________________(Years)
Education : _____________________
Experience : _____________________
Mobile No.	: _____________________
Email address	: _____________________
Address in KSA	: _____________________
Address in Pakistan	: _____________________
In the wake of current labor issues for nonpayment of dues by certain employer companies, our nationals are faced with employment issues. The embassy has made all its efforts to resolve their problems. As part of those efforts, the embassy is making all possible efforts to get our nationals (those who are interested in transferring their services) re-employed into other companies. Those interested are requested to send their CVs at feedback@pakembassyksa.com so that the Embassy makes arrangements for their employment as per their profession with the companies requiring their services.
© 2022 Embassy of Pakistan | Service to community by ABSOLUTE SOLUTIONS.


Through August 20, in Washington, D.C.
Peter Voulkos, Plate, 1963, glazed stoneware, torn, sliced, gouged, sgraffito.
By 1960, it looked as if Peter Voulkos was going to have a stellar career. That was the year Voulkos, who was based in the San Francisco Bay Area, exhibited six sculptures and six paintings in a "New Talent" show curated by the inestimable Peter Selz at the Museum of Modern Art. These displays, held in the penthouse gallery of MoMA's original building, were designed to call attention to artists not represented by a gallery in New York.
Already much admired, Voulkos worked in clay and had taught ceramics at Black Mountain College in North Carolina, the Los Angeles County Art Institute (now the Otis College of Art and Design), and the University of Montana, before recently joining the faculty of the University of California, Berkeley. At the Pasadena Art Museum in 1958–59, when he was 34, he'd had a solo show of sculptures and paintings. And, since 1950, he'd been winning all sorts of medals and purchase awards, capped by the Rodin Museum prize at the first Paris Biennale, held at the Musee d'art Moderne de la Ville de Paris in 1959.
Peter Voulkos, Untitled, 1956, stoneware and dioxide iron oxide with manganese, thrown and slab constructed, assembled, sgraffito.
However, instead of taking off, Peter Voulkos's reputation stalled. On the basis of almost three dozen works featured in "Voulkos: The Breakthrough Years," on view at the Renwick Gallery of the Smithsonian American Art Museum in Washington, D.C., this seems surprising. At first, you might suspect that his failure to achieve fame was because of the medium he'd mastered. But, back in the day, the field of ceramics was not marginalized in the way it would be later. As it was, the checklist for the three-dimensional objects on view in 1960 at MoMA, three of which are included in the current show, were labeled as sculpture, and that was the term used in the review published in Arts magazine.
There's the rub. Peter Voulkos was indisputably a pioneer who changed the dynamic of ceramics: both its look as well as its time honored techniques. He achieved this twofold feat, however, during a period of transition. Like his colleagues Mark di Suvero and John Chamberlain on the East Coast, Voulkos had one foot resting in the Abstract Expressionist period and his other poised on the threshold of the times-they-are-a-changin' '60s. While his tall, brash works took his field of expertise in a new direction, a cooler, more hip aesthetic was about to envelop the art world.
Though it was clear from the outset that Voulkos was immensely talented, his career began somewhat conventionally. The earliest works in "The Breakthrough Years" are functional jars and vases from the early 1950s. On their textured—or, in ceramics parlance, speckled—surfaces, the artist skillfully applied linear motifs with innovative procedures. Some of his themes evoke cave paintings crossed with the contemporaneous imagery of Pablo Picasso. He also was inspired by the newfangled cut-outs of Henri Matisse to attach to his vases heavy blotting paper he'd shaped into heraldic forms, wet them, apply several layers of white slip over them, and then peel them off, leaving recessed areas he would decorate.
Peter Voulkos, Remington #2, ca. 1961.
By 1956, Voulkos, who'd been living in Los Angeles for two years, still was making vases that were not yet wholly unorthodox. When you take a close look, though, you notice he'd begun adding small slabs he'd constructed by hand to his wheel-thrown vessels. And he'd adopted a topsy-turvy attitude. At the Renwick show, which was organized by Andrew Perchuk, deputy director of the Getty Research Institute, and Glenn Adamson, there's a work where the artist turned both a base—or, as the jargon has it, a foot—that resembles a soup bowl, as well as the vase it supports, upside down.
At this point, Voulkos was also stacking elements. He'd put one vase on top of another on top of another. He punched holes into the surfaces of his vessels. And, he toyed with issues of balance. He even stopped working before he was sure he was finished (just the way Helen Frankenthaler once said that she didn't want to dot the i's, figuratively speaking, in her paintings).
Peter Voulkos, Sitting Bull, 1959, glazed stoneware and slip, thrown and slab constructed, paddled, sgraffito.
Meanwhile, using innovative practices he pioneered, Voulkos accrued valuable time to make changes and additions that had previously not been possible. Increasing the size of his sculptures, which entailed keeping them wet longer, went hand-in-hand with his ability to work more slowly. As he once explained, "I was trying to learn to throw big chunks of clay—one hundred pounds or so to make continuous two-foot cylinders with thick bottoms." Before this, ceramicists had thrown a maximum of ten pounds of clay. And since they were working small, they ably formed their vessels and such with their hands. Voulkos had to exert more pressure from his entire body. Additionally, he had to tinker with the kilns, which were typically too small for the massive—in some cases, person-sized works—he was making. Once he figured out this step, he was set. It's said that the sculpture on the announcement for his solo show held in L.A. in 1959 took five days to fire.
Then, for a brief period, Voulkos's ceramic sculptures were "carved and pounded out of shape," as exhibition catalogue contributor Barbara Paris Gifford has put it. There are sections that bulge and protrude as well as areas that have been gouged out and covered with slash marks. For a while, his work became asymmetrical and was no longer graceful. The artist applied his colors haphazardly. Still, with their alternately lumpy and ragged treatments, it's exciting to be able to walk around these sculptures and consistently discover totally new aspects.
Ever restless, Voulkos began making bronze abstractions during the mid-1960s. He even participated in "American Sculpture of the Sixties," the landmark show held at the Los Angeles County Museum of Art in 1967. If nothing else, Pirelli (1967), which later entered the collection of the Museum of Fine Arts, Boston, makes it clear that Voulkos was indeed a bona fide sculptor taking cues from the masters of his time, both American welders as well as European modelers and carvers. A number of works he initially made in clay and then cast in bronze are on the grounds of LongHouse Reserve in East Hampton.
The show at the Renwick closes with a group of 1968 works from Voulkos's "Blackwares" series. Named for their iron-like coloration, the display comprises 14 pots and 5 plates. In various combinations, the artist stacked cylinders, bowls, plates, and spouts, his innate classicism coming through once again.


As most of you already know LiverFoundation-NE.org has been renovating it's office for around 7 or 8 months. The entire renovation was supposed to only take 3 months to finish, but we've had numerous issues with a few different contractors. We can't even begin to explain how difficult it has been to find reliable, local contractors who will tell you how it is instead of just saying what you want to hear. We initially chose contractors that offered the best prices, but we quickly found out that they purposely bid low just to win the contract and then they would just keep adding fees. We had trouble finding roofing contractors, concrete contractors, and HVAC contractors until we found Proven Contractor. Proven Contractor has been a total life saver, and we will never hire a contractor that's not on ProvenContractor.com ever again. Proven Contractor reviews and verifies that contractors are licensed and insured (more difficult than it sounds) and all of the contractors we've hired from them have been reliable and affordable and most importantly honest. Check out ProvenContractor.com for more information or to find a local contractor in your area.
medicinenet Liver cancer (hepatocellular carcinoma) is a cancer arising from the liver. It is also known as primary liver cancer or hepatoma. The liver is made up of different cell types (for example, bile ducts, blood vessels, and fat-storing cells). However, liver cells (hepatocytes) make up 80% of the liver tissue. Thus, the majority of primary liver cancers (over 90%-95%) arises from liver cells and is called hepatocellular cancer or carcinoma. When patients or physicians speak of liver cancer, however, they are often referring to cancer that has spread to the liver, having originated in other organs (such as the colon, stomach, pancreas, breast, and lung). More specifically, this type of liver cancer is called metastatic liver disease (cancer) or secondary liver cancer. This is a much more common problem around the world than primary liver cancer and frequently leads to confusion, because the term liver cancer actually can refer to either metastatic liver cancer or hepatocellular cancer. The subject of this article is hepatocellular carcinoma, which I will refer to as liver cancer. What is the scope of the liver cancer problem? Liver cancer is the third most common cancer in the world.
A deadly cancer, liver cancer will kill almost all patients who have it within a year. In 2000, it was estimated that there were about 564,000 new cases of liver cancer worldwide, and a similar number of patients died as a result of this disease. About three-quarters of the cases of liver cancer are found in Southeast Asia (China, Hong Kong, Taiwan, Korea, and Japan). Liver cancer is also very common in sub-Saharan Africa (Mozambique and South Africa). The frequency of liver cancer in Southeast Asia and sub-Saharan Africa is greater than 100 cases per 100,000 population. In contrast, the frequency of liver cancer in North America and Western Europe is much lower, less than five per 100,000 population. However, the frequency of liver cancer among native Alaskans is comparable to that seen in Southeast Asia. This reflects the prevalence of hepatitis B infection, which is the most common cause of this cancer worldwide. Recent data show, however, that the frequency of liver cancer in the U.S. overall is rising. This increase is due primarily to rising obesity and diabetes rates, and to chronic hepatitis C, another infection of the liver that causes liver cancer.In the U.S., the highest frequency of liver cancer occurs in immigrants from Asian countries, where liver cancer is common.
The frequency of liver cancer among Caucasians is the lowest, whereas among African-Americans and Hispanics, it is intermediate. The frequency of liver cancer is high among Asians because liver cancer is closely linked to chronic hepatitis B infection. This is especially so in individuals who have been infected with chronic hepatitis B for most of their lives (it is usually a childhood disease in Asia). If you take a world map depicting the frequency of chronic hepatitis B infection, you can easily superimpose that map on a map showing the frequency of liver cancer. On the other hand, in Japan, North America and Europe, hepatitis C infection is a much more common cause; alcohol abuse is also an important contributing factor. All of these diseases cause continual damage to the liver, which can result in severe scarring (cirrhosis) that then can lead to cancer. In areas where liver cancer is more common and associated with hepatitis B, the cancer usually develops in people in their 30s and 40s, as opposed to other areas of the world, where they are in their 60s and 70s. This is because it generally takes about 30 years of chronic damage to the liver before the cancer grows large enough to become obvious. Men are much more likely than women to have liver cancer, especially if they have hepatitis and cirrhosis. Regardless of the cause, patients with a history of alcohol abuse as well are much sicker when they initially develop the cancer. In North America, up to one-quarter of people with liver cancer have no obvious risk factors; they are generally healthier and do much better with treatment. What are liver cancer causes and risk factors? Hepatitis B can be caught from contaminated blood products or used needles or sexual contact but is frequent among Asian children from contamination at birth or even biting among children at play. The role of hepatitis B virus (HBV) infection in causing liver cancer is well established.
Several lines of evidence point to this strong association. As noted earlier, the frequency of liver cancer relates to (correlates with) the frequency of chronic hepatitis B virus infection. In addition, the patients with hepatitis B virus who are at greatest risk for liver cancer are men with hepatitis B virus cirrhosis (scarring of the liver) and a family history of liver cancer. Perhaps the most convincing evidence, however, comes from a prospective (looking forward in time) study done in the 1970s in Taiwan involving male government employees over the age of 40. In this study, the investigators found that the risk of developing liver cancer was 200 times higher among employees who had chronic hepatitis B virus as compared to employees without chronic hepatitis B virus infection. Studies in animals also have provided evidence that hepatitis B virus can cause liver cancer. For example, we have learned that liver cancer develops in other mammals that are naturally infected with viruses related to the hepatitis B virus. Finally, by infecting transgenic mice with certain parts of the hepatitis B virus, scientists caused liver cancer to develop in mice that do not usually develop liver cancer. (Transgenic mice are mice that have been injected with new or foreign genetic material.) How does chronic hepatitis B virus cause liver cancer? In patients with both chronic hepatitis B virus and liver cancer, the genetic material of hepatitis B virus is frequently found to be part of the genetic material of the cancer cells. It is thought, therefore, that specific regions of the hepatitis B virus genome (genetic code) enter the genetic material of the liver cells.
This hepatitis B virus genetic material may then disrupt the normal genetic material in the liver cells, thereby causing the liver cells to become cancerous. The vast majority of liver cancer that is associated with chronic hepatitis B virus occurs in individuals who have been infected most of their lives. In areas where hepatitis B virus is not always present (endemic) in the community (for example, the U.S.), liver cancer is relatively uncommon. The reason for this is that most of the people with chronic hepatitis B virus in these areas acquired the infection as adults, and very few develop an ongoing (chronic active) infection, which happens as often as 15% of the time in Asia. Hepatitis C virus (HCV) infection is more difficult to get than hepatitis B. It usually requires direct contact with infected blood, either from contaminated blood products or needles. HCV is also associated with the development of liver cancer. In fact, in Japan, hepatitis C virus is present in up to 75% of cases of liver cancer. As with hepatitis B virus, the majority of hepatitis C virus patients with liver cancer have associated cirrhosis (liver scarring). In several retrospective-prospective studies (looking backward and forward in time) of the natural history of hepatitis C, the average time to develop liver cancer after exposure to hepatitis C virus was about 28 years. The liver cancer occurred about eight to 10 years after the development of cirrhosis in these patients with hepatitis C.
Several prospective European studies report that the annual incidence (occurrence over time) of liver cancer in cirrhotic hepatitis C virus patients ranges from 1.4%-2.5% per year. In hepatitis C virus patients, the risk factors for developing liver cancer include the presence of cirrhosis, older age, male gender, elevated baseline alpha-fetoprotein level (a blood tumor marker), alcohol use, and co-infection with hepatitis B virus. Some earlier studies suggested that hepatitis C virus genotype 1b (a common genotype in the U.S.) may be a risk factor, but more recent studies do not support this finding. The way in which hepatitis C virus causes liver cancer is not well understood. Unlike hepatitis B virus, the genetic material of hepatitis C virus is not inserted directly into the genetic material of the liver cells. It is known, however, that cirrhosis from any cause is a risk factor for the development of liver cancer. Therefore, it has been argued that hepatitis C virus, which causes cirrhosis of the liver, is an indirect cause of liver cancer. On the other hand, there are some chronic hepatitis C virus-infected individuals who have liver cancer without cirrhosis. So, it has been suggested that the core (central) protein of hepatitis C virus is the culprit in the development of liver cancer. The core protein itself (a part of the hepatitis C virus) is thought to impede the natural process of cell death or interfere with the function of a normal tumor suppressor (inhibitor) gene (the p53 gene). The result of these actions is that the liver cells go on living and reproducing without the normal restraints, which is what happens in cancer. Cirrhosis caused by chronic alcohol consumption is the most common association of liver cancer in the developed world. In fact, at autopsy, as many as half of alcoholics previously unsuspected to have cancer will have early evidence of cancer hidden within the liver. Many of these people are also infected with chronic hepatitis C virus.
The usual setting is an individual with alcoholic cirrhosis who has stopped drinking for 10 years and then develops liver cancer. It is somewhat unusual for an actively drinking alcoholic to develop liver cancer. What happens is that when the drinking is stopped, the liver cells try to heal by regenerating (reproducing). It is during this active regeneration that a cancer-producing genetic change (mutation) can occur, which explains the occurrence of liver cancer after the drinking has been stopped. More importantly, if an alcoholic does not stop drinking, he or she is unlikely to live long enough to develop the cancer. Alcoholics who are actively drinking are more likely to die from non-cancer related complications of alcoholic liver disease (for example, liver failure). Indeed, patients with alcoholic cirrhosis who die of liver cancer are about 10 years older than patients who die of non-cancer causes. Finally, as noted above, alcohol adds to the risk of developing liver cancer in patients with chronic hepatitis C virus or hepatitis B virus infections. Aflatoxin B1 is the most potent liver cancer-forming chemical known. It is a product of a mold called Aspergillus flavus, which is found in food that has been stored in a hot and humid environment. This mold is found in such foods as peanuts, rice, soybeans, corn, and wheat. Aflatoxin B1 has been implicated in the development of liver cancer in Southern China and sub-Saharan Africa. It is thought to cause cancer by producing changes (mutations) in the p53 gene. These mutations work by interfering with the gene's important tumor suppressing (inhibiting) functions. There are no medications that cause liver cancer, but female hormones (estrogens) and protein-building (anabolic) steroids are associated with the development of hepatic adenomas.
These are benign liver tumors that may have the potential to become malignant (cancerous). Thus, in some individuals, hepatic adenoma can evolve into cancer. Certain chemicals are associated with other types of cancers found in the liver. For example, thorotrast, a previously used contrast agent for diagnostic imaging studies, caused a cancer of the blood vessels in the liver called hepatic angiosarcoma. Also, vinyl chloride, a compound used in the plastics industry, can cause hepatic angiosarcomas that appear many years after the exposure. Liver cancer will develop in up to 30% of patients with hereditary hemochromatosis (a disorder in which there is too much iron stored in the body, including in the liver). Patients at the greatest risk are those who develop cirrhosis with their hemochromatosis. Unfortunately, once cirrhosis is established, effective removal of excess iron (the treatment for hemochromatosis) will not reduce the risk of developing liver cancer. Over the past decade, the incidence of liver cancer in the United States has risen significantly, paralleling the rise in obesity revitol hair removal cream. Although it is hard to separate the effects of diabetes from obesity on the liver, both conditions can cause chronic damage and accumulation of fat within the liver.. This is a disease called NASH (non-alcoholic steatohepatitis), which is present in up to 5% of North Americans. Fatty liver disease like this causes damage to the individual liver cells and may lead to cirrhosis in some people, thereby increasing the risk of liver cancer. Not only is the chance of developing the cancer enhanced, but patients with diabetes who undergo surgical removal of liver cancer have a higher chance of the cancer returning than do those without diabetes.
Individuals with most types of cirrhosis of the liver are at an increased risk of developing liver cancer. In addition to the conditions described above (hepatitis B, hepatitis C, alcohol, and hemochromatosis), alpha 1 anti-trypsin deficiency, a hereditary condition that can cause emphysema and cirrhosis, may lead to liver cancer. Liver cancer is also strongly associated with hereditary tyrosinemia, a childhood biochemical abnormality that results in early cirrhosis. Certain causes of cirrhosis are less frequently associated with liver cancer than are other causes. For example, liver cancer is rarely seen with the cirrhosis in Wilson's disease (abnormal copper metabolism) or primary sclerosing cholangitis (chronic scarring and narrowing of the bile ducts). It used to be thought that liver cancer is rarely found in primary biliary cirrhosis (PBC) as well. Recent studies, however, show that the frequency of liver cancer in PBC is comparable to that in other forms of cirrhosis. The initial symptoms (the clinical presentations) of liver cancer are variable. It is becoming much more common for patients to be identified by screening people at high risk for the cancer and finding the cancer before there are any symptoms at all. In countries where liver cancer is very common, the cancer generally is discovered at a very advanced stage of disease for several reasons. For one thing, areas where there is a high frequency of liver cancer are generally developing countries where access to health care is limited. For another, screening examinations for patients at risk for developing liver cancer are not available in these areas. In addition, patients from these regions may actually have more aggressive liver cancer disease. In other words, the tumor usually reaches an advanced stage and causes symptoms more rapidly. In contrast, patients in areas of low liver cancer frequency tend to have liver cancer tumors that progress more slowly and, therefore, remain without symptoms longer.
There Kent Wedding Photographer are no specific symptoms of liver cancer, and in fact, the earliest signs are usually subtle and can be mistaken for simple worsening of cirrhosis and liver function. Abdominal pain is uncommon with liver cancer and usually signifies a very large tumor or widespread involvement of the liver. Additionally, unexplained weight loss or unexplained fevers are warning signs of liver cancer in patients with cirrhosis. These symptoms are less common in individuals with liver cancer in the U.S. because these patients are usually diagnosed at an earlier stage. However, whenever the overall health of a patient with cirrhosis deteriorates, every effort should be made to look for liver cancer. A common initial presentation of liver cancer in a patient with compensated cirrhosis (meaning that there are no complications of liver disease) is the sudden onset of a complication. For example, the sudden appearance of ascites (abdominal fluid and swelling), jaundice (yellow color of the skin), or muscle wasting without causative (precipitating) factors (for example, alcohol consumption) suggests the possibility of liver cancer. What's more, the cancer can invade and block the portal vein (a large vein that brings blood to the liver from the intestine and spleen). When this happens, the blood will travel paths of less resistance, such as through esophageal veins. This causes increased pressure in these veins, which results in dilated (widened) veins called esophageal varices.
The patient then is at risk for hemorrhage from the rupture of the varices into the gastrointestinal tract. Rarely, the cancer itself can rupture and bleed into the abdominal cavity, resulting in bloody ascites. On physical examination, an enlarged, sometimes tender, liver is the most common finding. Liver cancers are very vascular (containing many blood vessels) tumors. Thus, increased amounts of blood feed into the hepatic artery (artery to the liver) and cause turbulent blood flow in the artery. The turbulence results in a distinct sound in the liver (hepatic bruit) that can be heard with a stethoscope in about one-quarter to one-half of patients with liver cancer. Any sign of advanced liver disease (for example, ascites, jaundice, or muscle wasting) means a poor prognosis. Rarely, a patient with liver cancer can become suddenly jaundiced when the tumor erodes into the bile duct. The jaundice occurs in this situation because both sloughing of the tumor into the duct and bleeding that clots in the duct can block the duct. In advanced liver cancer, the tumor can spread locally to neighboring tissues or, through the blood vessels, elsewhere in the body (distant metastasis). Locally, liver cancer can invade the veins that drain the liver (hepatic veins). The tumor can then block these veins, which results in congestion of the liver. The congestion occurs because the blocked veins cannot drain the blood out of the liver. (Normally, the blood in the hepatic veins leaving the liver flows through the inferior vena cava, which is the largest vein that drains into the heart.) In African patients, the tumor frequently blocks the inferior vena cava.
Blockage of either the hepatic veins or the inferior vena cava results in a very swollen liver and massive formation of ascites. In some patients, as previously mentioned, the tumor can invade the portal vein and lead to the rupture of esophageal varices. Regarding distant metastases, liver cancer frequently spreads to the lungs, presumably by way of the bloodstream. Usually, patients do not have symptoms from the lung metastases, which are diagnosed by radiologic (X-ray) studies. Rarely, in very advanced cases, liver cancer can spread to the bone or brain. These are an infrequent problem in many patients who do not live long enough to develop these complications.The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion. The liver is necessary for survival; there is currently no way to compensate for the absence of liver function. This organ plays a major role in metabolism and has a number of functions in the body, including glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification. It lies below the diaphragm in the thoracic region of the abdomen. It produces bile, an alkaline compound which aids in digestion, via the emulsification of lipids. The liver's highly specialized tissues regulate a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions. Medical terms related to the liver often start in hepato- or hepatic from the Greek word for liver, h?par The liver is a reddish brown organ with four lobes of unequal size and shape.
A human liver normally weighs between 1.4–1.6 kg (3.1–3.5 lb), and is a soft, pinkish-brown, triangular organ. It is both the largest internal organ (the skin being the largest organ overall) and the largest gland in the human body. It is located in the right upper quadrant of the abdominal cavity, resting just below the diaphragm. The liver lies to the right of the stomach and overlies the gallbladder. It is connected to two large blood vessels, one called the hepatic artery and one called the portal vein. The hepatic artery carries blood from the aorta whereas the portal vein carries blood containing digested nutrients from the small intestine and the descending colon. These blood vessels subdivide into capillaries which then lead to a lobule. Each lobule is made up of millions of hepatic cells which are the basic metabolic cells. The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. Supplying approximately 75% of the liver's blood supply, the hepatic portal vein carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remainder of its blood flow. Oxygen is provided from both sources; approximately half of the liver's oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries. Blood flows through the sinusoids and empties into the central vein of each lobule. The central veins coalesce into hepatic veins, which leave the liver and empty into the inferior vena cava. The term biliary tree is derived from the arboreal branches of the bile ducts.
The bile produced in the liver is collected in bile canaliculi, which merge to form bile ducts. Within the liver, these ducts are called intrahepatic (within the liver) bile ducts, and once they exit the liver they are considered extrahepatic (outside the liver). The intrahepatic ducts eventually drain into the right and left hepatic ducts, which merge to form the common hepatic duct. The cystic duct from the gallbladder joins with the common hepatic duct to form the common bile duct. Bile can either drain directly into the duodenum via the common bile duct or be temporarily stored in the gallbladder via the cystic duct. The common bile duct and the pancreatic duct enter the second part of the duodenum together at the ampulla of Vater. Apart from a patch where it connects to the diaphragm (the so-called "bare area"), the liver is covered entirely by visceral peritoneum, a thin, double-layered membrane that reduces friction against other organs. The peritoneum folds back on itself to form the falciform ligament and the right and left triangular ligaments. These "lits" are in no way related to the true anatomic ligaments in joints, and have essentially no functional importance, but they are easily recognizable surface landmarks. An exception to this is the falciform ligament, which attaches the liver to the posterior portion of the anterior body wall. Traditional gross anatomy divided the liver into four lobes based on surface features. The falciform ligament is visible on the front (anterior side) of the liver. This divides the liver into a left anatomical lobe, and a right anatomical lobe. If the liver is flipped over, to look at it from behind (the visceral surface), there are two additional lobes between the right and left. These are the caudate lobe (the more superior), and below Car Share this the quadrate lobe.
From behind, the lobes are divided up by the ligamentum venosum and ligamentum teres (anything left of these is the left lobe), the transverse fissure (or porta hepatis) divides the caudate from the quadrate lobe, and the right sagittal fossa, which the inferior vena cava runs over, separates these two lobes from the right lobe. Each of the lobes is made up of lobules; a vein goes from the centre of each best acne treatment lobule which then joins to the hepatic vein to carry blood out from the liver. On the surface of the lobules there are ducts, veins and arteries that carry fluids to and from them. Correspondence between anatomic lobes and Couinaud segments The central area where the common bile duct, hepatic portal vein, and hepatic artery proper enter is the hilum or "porta hepatis". The duct, vein, and artery divide into left and right branches, and the portions of the liver supplied by these branches constitute the functional left and right lobes. The functional lobes are separated by an imaginary plane joining the gallbladder fossa to the inferior vena cava. The plane separates the liver into the true right and left lobes. The middle hepatic vein also demarcates the true right and left lobes. The right lobe is further divided into an anterior and posterior segment by the right hepatic vein. The left lobe is divided into the medial and lateral segments by the left hepatic vein. The fissure for the ligamentum teres also separates the medial and lateral segments.
The medial segment is also called the quadrate lobe. In the widely used Couinaud (or "French") system, the functional lobes are further divided into a total of eight subsegments based on a transverse plane through the bifurcation of the main portal vein. The caudate lobe is a separate structure which receives blood flow from both the right- and left-sided vascular branches. The liver is found in all vertebrates, and is typically the largest visceral organ. Its form varies considerably in different species, and is largely determined by the shape and arrangement of the surrounding organs. Nonetheless, in most species it is divided into right and left lobes; exceptions to this general rule include snakes, where the shape of the body necessitates a simple cigar-like form. The internal structure of the liver is broadly similar in all vertebrates. An organ sometimes referred to as a liver is found associated with the digestive tract of the primitive chordate Amphioxus. However, this is an enzyme secreting gland, not a metabolic organ, and it is unclear how truly homologous it is to the vertebrate liver.The various functions of the liver are carried out by the liver cells or hepatocytes. Currently, there is no artificial organ or device capable of emulating all the functions of the liver. Some functions can be emulated by liver dialysis, an experimental treatment for liver failure. Further information: Proteins produced and secreted by the liver A large part of amino acid synthesis The liver performs several roles in carbohydrate metabolism: Gluconeogenesis (the synthesis of glucose from certain amino acids, lactate or glycerol).
Note that humans and some other mammals cannot synthesize glucose from glycerol. Glycogenolysis (the breakdown of glycogen into glucose) Glycogenesis (the formation of glycogen from glucose)(muscle tissues can also do this) The liver is responsible for the mainstay of protein metabolism, synthesis as well as degradation The liver also performs several roles in lipid metabolism: Cholesterol synthesis Lipogenesis, the production of triglycerides (fats). The liver produces coagulation factors I (fibrinogen), II (prothrombin), V, VII, IX, X and XI, as well as protein C, protein S and antithrombin. In the first trimester fetus, the liver is the main site of red blood cell production. By the 32nd week of gestation, the bone how to get your ex boyfriend back marrow has almost completely taken over that task. The liver produces and excretes bile (a yellowish liquid) required for emulsifying fats. Some of the bile drains directly into the duodenum, and some is stored in the gallbladder. The used car prices liver also produces insulin-like growth factor 1 (IGF-1), a polypeptide protein hormone that plays an important role in childhood growth and continues to have anabolic effects in adults. The liver is a major site of thrombopoietin production. Thrombopoietin is a glycoprotein hormone that regulates the free iphone production of platelets by the bone marrow. The breakdown of insulin and other hormones The liver breaks down hemoglobin, creating metabolites that are added to bile as pigment (bilirubin and biliverdin). The liver breaks down or press release distribution modifies toxic substances (e.g., methylation) and most medicinal products in a process called drug metabolism. This sometimes results in toxication, when the metabolite is more toxic than its precursor. Preferably, the toxins are conjugated to Best Man Speeches avail excretion in bile or urine. The liver converts ammonia to urea. The liver stores a multitude of substances, including glucose (in healthy living the form of glycogen), vitamin A (1–2 years' supply), vitamin D (1–4 months' supply), vitamin B12 (1-3 years' supply), iron, and copper. The liver is responsible for immunological effects- the good health reticuloendothelial system of the liver contains many immunologically active cells, acting as a 'sieve' for antigens carried to it via the portal system. The liver produces albumin, the major osmolar wrinkle cream component of blood serum. The liver synthesizes angiotensinogen, a hormone that is responsible for raising the blood pressure when activated by renin, an enzyme that is released wholesale silver jewellery when the kidney senses low blood pressure. The liver supports almost every organ in the body and is vital for survival. Because of its strategic location and multidimensional pyxism functions, the liver is also prone to many diseases. The most common include: Infections such as hepatitis A, B, C, E, alcohol damage, fatty liver, cirrhosis, cancer, drug damage (especially diy repair acetaminophen, cancer drugs) Many diseases of the liver are accompanied by jaundice caused by increased levels of bilirubin in the system.
The bilirubin results from the breakup of the solar power systems haemoglobin of dead red blood cells; normally, the liver removes bilirubin from the blood and excretes it through bile. There are also many pediatric liver diseases including USPS change of address biliary atresia, alpha-1 antitrypsin deficiency, alagille syndrome, progressive familial intrahepatic cholestasis, and Langerhans cell histiocytosis, to name but a few. Diseases that interfere with liver function will lead to derangement of these baby gift baskets processes. However, the liver has a great capacity to regenerate and has a large reserve capacity. In most cases, the liver only produces symptoms after extensive reverse phone lookup damage. Liver diseases may be diagnosed by liver function tests, for example, by production of acute phase proteins.The classic signs of liver damage include the following: Pale stools occur when stercobilin, a brown pigment, is absent from the stool. Stercobilin is derived from bilirubin metabolites best acne treatment produced in the liver. Dark urine occurs when bilirubin mixes with urine Bilirubin when it deposits in skin, causes an intense itch. Itching is the most common complaint Houston Personal Injury Lawyer by people who have liver failure. Often this itch cannot be relieved by drugs. Swelling of the abdomen, ankles and feet occurs because the liver fails to make Diamond Engagement Rings albumin. Excessive fatigue occurs from a generalized loss of nutrients, minerals and vitamins. Bruising and easy bleeding are other features of liver disease. The liver makes substances which help prevent bleeding. When liver damage occurs, these substances are no longer present and severe bleeding can occur. The diagnosis of liver function is made by blood tests. Liver function tests can readily pinpoint the extent of liver damage. If infection is suspected, then other serological tests are done. Sometimes one may require an ultrasound or a cars forum CT scan to image the liver. Physical exam of the liver is not accurate in determining the extent of liver damage.
Physical exam can only reveal presence of tenderness or size of liver but in all cases some type of radiological study is required to look at the liver. The ideal way to look at damage to the liver is with a biopsy. A biopsy is not required in all cases but may be necessary when the cause is unknown. The procedure is video interviewing done at the bedside and only requires local anesthetic. A small thin needle is inserted into the skin just below the rib cage and a biopsy is obtained. The tissue is sent to the laboratory where it is analyzed under a microscope. Sometimes the radiologist may perform a liver biopsy under ultrasound cash advance guidance if only a small area is involved. The liver is the only internal human organ capable of natural regeneration of lost tissue; as little as 25% of a liver can green marketing regenerate into a whole liver. This is predominantly due to the hepatocytes re-entering the cell cycle. That is, the hepatocytes go from the quiescent G0 phase to the G1 phase and undergo mitosis. This process is activated by the p75 receptors. There is also some evidence of bipotential stem cells, called ovalocytes or hepatic oval cells, which are thought to reside in the canals of Hering. These cells can differentiate into table tennis either hepatocytes or cholangiocytes, the latter being the cells that line the bile ducts. The capability for the liver to regenerate itself has been known since at least the times of the ancient Greeks, whose mythology includes a story about Prometheus being chained to a rock in the Caucasus seo company mountain and his liver being partially eaten during the day by an eagle only to "regenerate" in the night. The story, however, embellishes the speed with which this occurs. Human liver transplants were first performed by Thomas Starzl in the United States and Roy Calne in Cambridge, England in 1963 and 1965, respectively.
After resection of left lobe liver tumor Liver transplantation is the only option for those with irreversible liver failure. Most transplants are done for chronic liver diseases leading to cirrhosis, such as chronic hepatitis C, alcoholism, autoimmune hepatitis, and many tourbillon watches others. Less commonly, liver transplantation is done for fulminant hepatic failure, in which liver failure occurs over days to weeks. Liver allografts for transplant usually come from non-living donors who have died from fatal brain injury. Living donor liver transplantation is a technique in which a portion of a living person's liver is removed and used to replace the entire liver of the recipient. This was first performed in 1989 for pediatric liver transplantation. Only 20% of an adult's liver (Couinaud segments 2 and 3) is needed to serve as a liver allograft for an infant or small child. More recently, adult-to-adult liver transplantation has been done using the donor's right hepatic lobe which amounts to 60% of the fat burning furnace review liver. Due to the ability of the liver to regenerate, both the donor and recipient end up with normal liver function if all goes well. This procedure is more controversial as it Group Halloween Costumes entails performing a much larger operation on the donor, and indeed there have been at least 2 donor deaths out of the first several hundred cases. A recent publication has addressed the outdoor table tennis table problem of donor mortality, and at least 14 cases have been found. The risk of postoperative complications (and death) is far greater in right-sided operations than that in left-sided operations. With the recent advances of non-invasive imaging, living liver donors usually have to undergo tinnitus treatment imaging examinations for liver anatomy to decide if the anatomy is feasible for donation. The evaluation is usually performed by multi-detector row computed tomography (MDCT) and magnetic resonance imaging (MRI). MDCT is good in vascular anatomy and volumetry. MRI is used for biliary tree anatomy. Donors with very unusual vascular anatomy, which makes them unsuitable for donation, could be screened out to avoid unnecessary operations. MDCT image. Arterial anatomy contraindicated for liver donation. MDCT fish oil image.
Portal venous anatomy contraindicated for liver donation. MDCT image. 3D image created by MDCT can clearly visualize the liver, measure the liver volume, and plan the dissection plane to corporate entertainment facilitate the liver transplantation procedure. Phase contrast CT image. Contrast is perfusing the right liver but not the left due to a left portal vein thrombus. In the growing fetus, a major bedroom furniture source of blood to the liver is the umbilical vein which supplies nutrients to the growing fetus. The umbilical vein enters the abdomen at the umbilicus, and passes upward CD replication along the free margin of the falciform ligament of the liver to the inferior surface of the liver. There it joins with the left branch of the portal vein. The ductus venosus Portable Staging carries blood from the left portal vein to the left hepatic vein and then to the inferior vena cava, allowing placental blood to bypass the liver. In the fetus, the liver develops nature sounds throughout normal gestation, and does not perform the normal filtration of the infant liver. The liver does not perform digestive processes because the fetus does not consume meals directly, but receives nourishment from the mother via the placenta. The fetal liver releases some blood stem cells that migrate to the fetal thymus, so 18th birthday ideas initially the lymphocytes, called T-cells, are created from fetal liver stem cells. Once the fetus is delivered, the formation of blood stem cells in infants shifts to the red bone marrow. After birth, the umbilical vein and ductus venosus are completely obliterated in two to five days; the former becomes the ligamentum teres and the latter becomes the ligamentum venosum. In the disease state of cirrhosis and portal hypertension, the umbilical vein can open up again. The liver has always been an important symbol in occult physiology. As the largest organ, the CD replication one containing the most blood, it was regarded as the darkest, least penetrable part of man's innards.
Thus it was considered to contain the secret of fate and was used for fortune-telling. In Plato, and in later physiology, the liver represented the darkest passions, particularly the bloody, smoky ones of wrath, jealousy, and greed which drive men to action. Thus the liver meant the impulsive attachment to life itself. In Greek mythology, Prometheus was punished by the gods for revealing fire to humans, by being chained to a rock where a vulture (or an eagle) would peck out his liver, which would regenerate overnight. (The liver is the only human internal Portable Staging organ that actually can regenerate itself to a significant extent.) Many ancient peoples of the Near East and Mediterranean areas practised a type of divination called nature sounds haruspicy, whereby they tried to obtain information from examining the livers of sheep and other animals. The Talmud (tractate Berakhot 61b) refers to the liver as the Hair Transplant seat of anger, with the gallbladder counteracting this. The Persian, Urdu, and Hindi languages refer to the liver in figurative speech to indicate courage and strong feelings, or "their best"; e.g., "This Mecca has thrown to you the pieces of its liver!". The term jan e jigar, literally "the strength (power) of my liver", is a term of endearment in Urdu. In Persian slang, jigar is used as an adjective for any object which is desirable, especially women. In the Zulu language, the word for liver (isibindi) is the same as the word for courage. The louis vuitton handbags legend of Liver-Eating Johnson says that he would cut out and eat the liver of each man killed after dinner. In the motion picture The Message, Hind bint Utbah is implied or portrayed eating the liver of Hamza ibn 'Abd al-Muttalib during the Battle of Uhud. Although there are narrations that suggest that Hind did "taste", rather than eat, the liver of Hamza, the authenticity of these narrations have to be questioned. Bile or gall is a bitter-tasting, dark green to yellowish brown fluid, produced by the liver of most vertebrates, that aids the process of digestion of lipids in the small intestine. In many species, bile is stored in the gallbladder and upon eating is discharged into the duodenum. In the medical theories prevalent in the West from Classical Antiquity up to the Middle Ages, the body's health depended on the equilibrium between four "humors" or vital fluids: blood, phlegm, "yellow bile" (or ichor) and "black bile".
Excesses of the last two humors were supposed to produce aggression and depression, respectively; and the Greek names for them gave rise to the English words "cholera" and "melancholia". Those same theories explain the derivation of the English word "bilious" from "bile", and the meaning of "gall" in English as "exasperation" or "impudence". Bile is produced by hepatocytes in the liver, draining through the many bile ducts that penetrate the liver. During this process, the epithelial cells add a watery solution that is rich in bicarbonates that dilutes and increases alkalinity of the solution. Bile then flows into the common hepatic duct, which joins with the cystic duct from the gallbladder to form the common bile duct. The common bile duct in turn joins with the pancreatic duct to empty into the duodenum. If the sphincter of Oddi is closed, bile is prevented from draining into the intestine and instead flows into the gallbladder, where it is stored and concentrated to up to five times its original potency between meals. This concentration occurs through the absorption of water and small electrolytes, while retaining all the original organic molecules. Cholesterol is also released with the bile, dissolved in the acids and fats found in the concentrated solution. When food is released by the stomach into the duodenum in the form of chyme, the duodenum releases cholecystokinin, which causes the gallbladder to release the concentrated bile to complete digestion. The human liver can produce close to one litre of bile per day (depending on body size). About 95% of the salts secreted in bile are reabsorbed in the terminal ileum and re-used. Blood from the ileum flows directly to the hepatic portal vein and returns to the liver where the hepatocytes reabsorb the salts and return them to the bile ducts to be re-used, sometimes two to three times with each meal. Action of bile salts in digestion Bile acts to some extent as a surfactant, helping to emulsify the fats in the food. Bile salt anions have a hydrophilic side and a hydrophobic side, and therefore tend to aggregate around droplets of fat (triglycerides and phospholipids) to form micelles, with the hydrophobic sides towards the fat and hydrophilic towards the outside.
The hydrophilic sides are positively charged due to the lecithin and other phospholipids that compose bile, and this charge prevents fat droplets coated with bile from re-aggregating into larger fat particles. Ordinarily, the micelles in the duodenum have a diameter of around 14-33 ?m. The dispersion of food fat into micelles thus provide a largely increased surface area for the action of the enzyme pancreatic lipase, which actually digests the triglycerides, and is able to reach the fatty core through gaps between the bile salts. A triglyceride is broken down into two fatty acids and a monoglyceride, which are absorbed by the villi on the intestine walls. After being transferred across the intestinal membrane, fatty acids are reformed into triglicerides, then absorbed into the lymphatic system through lacteals. Without bile salts, most of the lipids in the food would be passed out in feces, undigested. Since bile increases the absorption of fats, it is an important part of the absorption of the fat-soluble substances, such as the vitamins D, E, K and A. Besides its digestive function, bile serves also as the route of excretion for bilirubin, a byproduct of red blood cells recycled by the liver. Bilirubin derives from hemoglobin by glucuronidation. The alkaline bile also has the function of neutralizing any excess stomach acid before it enters the ileum, the final section of the small intestine. Bile salts also act as bactericides, destroying many of the microbes that may be present in the food. Bile from slaughtered animals can be mixed with soap. This mixture, called bile soap, can be applied to textiles a few hours save marriage before washing and is a traditional and rather effective method for removing various kinds of tough stains. Bile also helps to neutralise the chyme from the stomach with sodium bicarbonate. The cholesterol contained in bile will occasionally accrete into lumps in the gallbladder, forming gallstones.
On an empty stomach – after repeated vomiting, for example – a person's vomit may be green or dark yellow, and very bitter. The bitter and greenish component is bile. (The color of bile is often likened to "fresh-cut grass", but in a vomit it may be mixed with other components in the stomach to look greenish yellow or dark yellow.) In the absence of bile, fats become indigestible and are instead excreted in feces, a condition called steatorrhea. Feces lack their characteristic brown colour and instead are white or grey, and greasy. Steatorrhea can lead to deficiencies in essential fatty acids and fat-soluble vitamins. In addition, past the small intestine (which is normally responsible for absorbing fat from food) the gastrointestinal tract and gut flora are not adapted to processing fats, leading to problems in the large intestine. Liver function tests (LFTs or LFs), which include liver enzymes, are groups of clinical biochemistry laboratory blood assays designed to give information about the state of a patient's liver. Most liver diseases cause only mild symptoms initially, but it is vital that these diseases be detected early. Hepatic (liver) involvement in some diseases can be of crucial importance. This testing is performed by a medical technologist on a patient's serum or plasma sample obtained by phlebotomy. Some tests are associated with functionality (eg. albumin); some with cellular integrity (eg. transaminase) and some with conditions linked to the biliary tract (gamma-glutamyl transferase and alkaline phosphatase). Several biochemical tests are useful in the evaluation and management of patients with hepatic dysfunction. These tests can be used to (1) detect the presence of liver disease, (2) distinguish among different types of liver disorders, (3) gauge the extent of known liver damage, and (4) follow the response to treatment.
This section is missing citations or needs footnotes. Please help add inline citations to guard against copyright violations and factual inaccuracies. (November 2008) Measurement Significance Reference range (Normal Values) Albumin (Alb) Albumin is a protein made specifically by the liver, and can be measured cheaply and easily. It is the main constituent of total protein; the remaining fraction is called globulin (including the immunoglobulins). Albumin levels are decreased in chronic liver disease, such as cirrhosis. It is also decreased in nephrotic syndrome, where it is lost through the urine. Poor nutrition or states of protein catabolism may also lead to hypoalbuminaemia. The half-life of albumin is approximately 20 days. Albumin is not considered to be an especially useful marker of liver synthetic function; coagulation factors (see below) are much more sensitive. 3.9 to 5.0 g/dL Alanine transaminase (ALT) Alanine transaminase (ALT), also called Serum Glutamic Pyruvate Transaminase (SGPT) or Alanine aminotransferase (ALAT) is an enzyme present in hepatocytes (liver cells). When a cell is damaged, it leaks this enzyme into the blood, where it is measured. ALT rises dramatically in acute liver damage, such as viral hepatitis or paracetamol (acetaminophen) overdose. Elevations are often measured in multiples of the upper limit of normal (ULN). 9 to 60 IU/L Aspartate transaminase (AST) Aspartate transaminase (AST) also called Serum Glutamic Oxaloacetic Transaminase (SGOT) or aspartate aminotransferase (ASAT) is similar to ALT in that it is another enzyme associated with liver parenchymal cells. It is raised in acute liver damage, but is also present in red blood cells, and cardiac and skeletal muscle and is therefore not specific to the liver. The ratio of AST to ALT is sometimes useful in differentiating between causes of liver damage.Elevated AST levels are not specific for liver damage, and AST has also been used as a cardiac marker. 10 to 40 IU/L Alkaline phosphatase (ALP) Alkaline phosphatase (ALP) is an enzyme in the cells lining the biliary ducts of the liver. ALP levels in plasma will rise with large bile duct obstruction, intrahepatic cholestasis or infiltrative diseases of the liver.
ALP is also present in bone and placental tissue, so it is higher in growing children (as their bones are being remodelled) and elderly patients with Paget's disease. 30 to 120 IU/L Total bilirubin (TBIL) Bilirubin is a breakdown product of heme (a part of haemoglobin in red blood cells). The liver is responsible for clearing the blood of bilirubin. It does this by the following mechanism: bilirubin is taken up into hepatocytes, conjugated (modified to make it water-soluble), and secreted into the bile, which is excreted into the intestine. Increased total bilirubin causes jaundice, and can signal a number of problems: 1. Prehepatic: Increased bilirubin production. This can be due to a number of causes, including hemolytic anemias and internal hemorrhage. 2. Hepatic: Problems with the liver, which are reflected as deficiencies in bilirubin metabolism (e.g. reduced hepatocyte uptake, impaired conjugation of bilirubin, and reduced hepatocyte secretion of bilirubin). Some examples would be cirrhosis and viral hepatitis. 3. Posthepatic: Obstruction of the bile ducts, reflected as deficiencies in bilirubin excretion. (Obstruction can be located either within the liver or in the bile duct. Direct bilirubin (Conjugated Bilirubin) The diagnosis is narrowed down further by looking at the levels of direct bilirubin. If direct (i.e. conjugated) bilirubin is normal, then the problem is an excess of unconjugated bilirubin, and the location of the problem is upstream of bilirubin excretion. Hemolysis, viral hepatitis, or cirrhosis can be suspected. If direct bilirubin is elevated, then the liver is conjugating bilirubin normally, but is not able to excrete it. Bile duct obstruction by gallstones or cancer should be suspected. Gamma glutamyl transpeptidase (GGT) Although reasonably specific to the liver and a more sensitive marker for cholestatic damage than ALP, Gamma glutamyl transpeptidase (GGT) may be elevated with even minor, sub-clinical levels of liver dysfunction. It can also be helpful in identifying the cause of an isolated elevation in ALP. GGT is raised in alcohol toxicity chronic).


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Trump Urges Erdogan to Do Something For Release of Jailed US Pastor
By Staff Writer	 On Jul 18, 2018
U.S. Pastor Andrew Brunson in Izmir. (Photo: Turkish media)
U.S. President Donald J. Trump has called on his Turkish counterpart Recep Tayyip Erdogan to do something for the release of jailed U.S. Pastor Andrew Brunson after a court refused to free him on Wednesday. Trump called the court verdict a "total disgrace."
In another hearing yesterday, the Turkish court in the western province of Izmir refused to release U.S. Pastor Brunson who has been imprisoned pending trial for 19 months over charges of espionage and terrorism.
The court ruling came despite Brunson's lawyer hinted that the pastor would be released this time.
The ongoing imprisonment of the U.S. pastor remains a key point of contention and discord between Turkey and the U.S.
U.S. President Donald J. Trump expressed strong criticism on his Twitter account.
A total disgrace that Turkey will not release a respected U.S. Pastor, Andrew Brunson, from prison. He has been held hostage far too long. @RT_Erdogan should do something to free this wonderful Christian husband & father. He has done nothing wrong, and his family needs him!
Trump said Pastor Brunson "has been held hostage far too long." His description of the pastor's imprisonment as "being held hostage" is the first time an acknowledgment of a policy what Western diplomats and experts say "hostage policy" by Ankara.
The U.S. president insisted that the pastor has done nothing wrong.
Pastor Brunson faces charges of military espionage on behalf of foreign countries, abetting outlawed Kurdish militants and membership in a Muslim civil society group accused by the Turkish government of organizing a failed coup in July 2016.
The Wednesday decision caused a sense of disappointment on the part of the U.S. officials. Philip Kosnett, the U.S. charge d'affaires in Turkey, expressed his dismay and said he was disappointed.
"I have the indictment, I have attended three hearings, I don't believe there is any indication that Pastor Brunson is guilty of any sort of criminal or terrorist activity," he said, according to Washington Post.
The U.S. State Department also showed a reaction to the decision. "We have seen no credible evidence that Mr. Brunson is guilty of these crimes. The case against him is built on anonymous accusations and speculation," a State Department official told Globe Post Turkey.
"We strongly believe that he is innocent, and we call on the Turkish government to resolve his case in a timely, transparent, and fair manner."
The decision came two weeks after two U.S. senators visited President Recep Tayyip Erdogan in Ankara in a bid to secure the release of the pastor.
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