World Liver day is April 19.

Incidentally on April 19 1987 was the first time "The Simpsons" was aired.

Hepatitis C is curable with an 8 to 12 week treatment

John Meillon has a bar named after him at the "Oaks" at Neutral Bay, a pub he used to hang out at.

Bruce Lee apparently died of cerebral oedema secondary to an adverse reaction to "Equagesic" a combination of Aspirin and Meprobamate.

It occurs quite often in patients with ascites. They need an ascitic tap to look for white cells (will be > 250-500/mm3). Treat with IV Ceftriaxone 1gm daily or Cefotaxime 2gm q8hr. IV Albumin 1.5gm/kg is also commonly given if the patient's Urea, Bilirubin or creatinine is elevated.

Scary movie---brilliantly acted.

The flapping tremor may occur with more advanced hepatic encephalopathy.

Immunotherapy is useful in patients with advanced stage liver cancer with preserved liver function. Sorafenib was shown in the SHARP trial to improve survival in this group from 7.9 to 10.7 months. Better than nothing as long as the side effects aren't too bad.

Very early on following an ingestion ALT may be normal but a rise > 1000 IU/l is taken to represent hepatotoxicity. Raised levels of ALT and AST usually mean hepatocellular damage however ALT is more specific to the liver as AST is also found in cardiac and skeletal muscle as well as red blood cells.

The high portal vein pressure pushes out fluid into the peritoneal cavity made worse by the reduced oncotic pressure caused by low blood albumin levels (because the liver is unable to make the normal amount of protein as it fails).

High concentrations of Vitamin A are also found in seal, polar bear and moose livers. The above story is generally accepted as true. Some scholars however believe that Mawson would have noted the effects of Vitamin A toxicity in his diary but apparently he did not.