Pierce v. Society of Sisters Research Paper Example | Topics and Well Written Essays - 2750 words

Pierce v. Society of Sisters - Research Paper Example Is it poible for the state to demand that all children attent public school? In an undisputed decision, Supreme Court ruled on June 1, 1925 in contradiction of the State and in favor of parents in this case. According to the Court, this law violated Due Process Clause of Fourteenth Amendment: ...the Act of 1922 irrationally affects the freedom of parents and guardians to direct the education of children and upbringing of their children under their control. As frequently heretofore pointed out, the rights guaranteed by Constitution might not be curtailed by legislation that has no sensible relation to some purpose within the capability of a state. Fundamental theory of liberty that all governments recognized by this union, repose rejects any overall power of state to regulate its children by compelling them to admit instruction from only public teachers. Surpeme Court did this, though, it specified that a State has authority to require children to join some school and power to control schools to see to it that they are doing a good job at their education. Following this way, it confirmed the interest government has in mingling the young to citizenship, but repudiates nevertheless that the State has a domination in this project. These poored cold water on some statesas they were worried about the impact of the â€Å"foreign† and immigrant’s values well-thought-out public schools as a source of help; therefore these states enlisted laws intentionally to use these schools in order to promote common American culture. And on November 7 in 1922, Oregon electorates passed an ingenuity that rewritten Oregon Law Section 5259, which was the Compulsory Education Act. This ingenuity was mainly eliminate parochial schools. Accordingly, it led to a severe loss of revenue for private schools like the Non-sectarian and the Hill military academia! In conjunction, parents began withdrawing their children away from these schools in the untruthful believe that these will soon end. These laws were mainly aimed at eradicating Catholics schools. The Compulsory Education Act, preceding amendments, had demanded that all Oregon children between the age of eight to sixteen years to attend the public school. This was wit h exceptions. 1. Those mentally retarded/ physically unable to attend school 2. Those who had just graduated from their eighth grade 3. Those living more than a quantified distance by road from a nearby school 4. Those children thare are undergoing home-schooling or those that are tutored 5. Those that are attending a state

Civil War Essay Example | Topics and Well Written Essays - 500 words - 2

Civil War - Essay Example The sovereignty they believed was their right was constantly threatened in the period leading up to the Civil War as the balance of power moved from the Southern States to the Northern. It was felt that these States were being eroded as their ability to self-determine slowly changed. Particularly the Northern States’ greater voting power was questioned by Southern leaders such as John Calhoun, who advocated secession from the Union if certain issues were not resolved. He argued that the Union could eventually only be held together by the superior numbers, and the superior wealth of the Northern States as they forced the South to remain in the Union (Calhoun, 1850). It was particularly in the Nullification ordinances that the South expressed resistance to Northern dominance. For example in 1828, a Tariff was imposed on foreign imports by the Federal Government. The Southern States argued that this tariff was intended to favor domestic manufacturers and only certain foreign manufacturers, primarily based on Northern business interests. In fact, it was felt that the Tariff of 1928 â€Å"exceeded its just powers †¦ and †¦ the true meaning and intent of the Constitution† (Calhoun, 1832, & The Constitution of the United States of America Overview, 2012). Thus Ordinances of Nullification were published by the Southern States (for example the South Carolina Ordinance of Nullification) declaring that this and other federal laws would not be honored by these States. The North’s response can be summarized in the words of President Andrew Jackson, that United States laws are â€Å"paramount to State constitutions and laws†. (Jackson, 1932) Similarly, slavery was threatened, and consequently so was the way of life, economic prosperity and a perceived equality with all the States in the Union in the Southern States. As world opinion moved against Slavery, so too did the dominant political opinion among the Northern States. For Southern

Case Study Essay Example | Topics and Well Written Essays - 500 words - 36

Case Study - Essay Example The expenses that are incurred in buying a new or second hand printer are as follows; By comparing the prices above, it is evident that buying a second hand high speed printer is more cost effective/cheaper than buying a new high speed printer. However, this printer is four year old, and it is estimated that it will cost the company  £15,000 of expenses for repairs and lost business. The expenses incurred in maintaining the second hand printer is large enough to reduce revenue significantly. It is, therefore, not recommendable to obtain a high speed digital printer by buying a second hand Xerox DocuPrint 135MX high speed digital printer. Although a new printer will cost higher than a second hand printer, it will last longer without involving repair and maintenance costs, while in the warranty period, and it is also a fixed overhead. The only disadvantage it has is that it will potentially generate  £33,950 in revenue. This revenue, however, is the actual profit margin, which is usually accepted at approximately 20 percent profit margin, and this means that it will take the company owner at least seven years to recover his investment. It is evident from the two illustrations above that both buying a brand new and a second hand high speed digital printer will make the company incur large losses. In order to avoid these loses, I recommend that my brother should acquire the printer on a monthly leasing deal, with a get out clause built in after every year, should the machine not work well, or new versions with new technology are introduced into the market while the printer is on a leasing. Through leasing, repair and maintenance costs are incurred by the leasing company, and this will be additional overhead to be considered by the manager if he wants to buy a new

Social Psychology Assignment Example | Topics and Well Written Essays - 500 words - 3

Social Psychology - Assignment Example Consequently, I seldom participated in get together or other social activities conducted within school premises by my class-fellows. It is therefore, the boys and girls considered me as a very temperamental, unpredictable and arrogant person. One of my girl class-fellows, called Sandy, was very naughty and lively student. She looked like a tom-boy, and participated in sports and games, and every mischief observed by the naughty students. She did not like such a book worm like me, and always displayed her disliking for too much study and no play in quite an innocent mode. She cited psychological causes that led humans towards isolation and described the reasons behind leading the lonely life. â€Å"Lonely people have an intense longing to be needed and wanted by someone else. Some people suffer from loneliness from time to time, and for some it’s a daily way of life. Most lonely people wear the affects of it on their face with a sad continence or a dejected look.† (Nicel y, 2008: 1) But it was not the case actually; rather, I wanted to spend most of my time in the world of literature, colors and imagination. I even had no care regarding the views my class-mates maintained about me. Time was passing with its usual flow, and everything appeared to be routine matter. Then one day one single event made revolutionary changes in my life. It was a pleasant April morning, when the speech contest was going to be held at school level. One student from 7th to 10th grade could participate in the contest. I was one of the spectators, when I found my class-teacher in a perplexed state. On enquiry, I came to know that the contester from our class was absent from the school and there was no one to represent our class. Since everyone knew that I had vast knowledge of almost all topics, the teacher requested me to represent the class. After little hesitation, I stepped forward and spoke at

Case Study Essay Example | Topics and Well Written Essays - 500 words - 36

Case Study - Essay Example The expenses that are incurred in buying a new or second hand printer are as follows; By comparing the prices above, it is evident that buying a second hand high speed printer is more cost effective/cheaper than buying a new high speed printer. However, this printer is four year old, and it is estimated that it will cost the company  £15,000 of expenses for repairs and lost business. The expenses incurred in maintaining the second hand printer is large enough to reduce revenue significantly. It is, therefore, not recommendable to obtain a high speed digital printer by buying a second hand Xerox DocuPrint 135MX high speed digital printer. Although a new printer will cost higher than a second hand printer, it will last longer without involving repair and maintenance costs, while in the warranty period, and it is also a fixed overhead. The only disadvantage it has is that it will potentially generate  £33,950 in revenue. This revenue, however, is the actual profit margin, which is usually accepted at approximately 20 percent profit margin, and this means that it will take the company owner at least seven years to recover his investment. It is evident from the two illustrations above that both buying a brand new and a second hand high speed digital printer will make the company incur large losses. In order to avoid these loses, I recommend that my brother should acquire the printer on a monthly leasing deal, with a get out clause built in after every year, should the machine not work well, or new versions with new technology are introduced into the market while the printer is on a leasing. Through leasing, repair and maintenance costs are incurred by the leasing company, and this will be additional overhead to be considered by the manager if he wants to buy a new

Academic Papers Essay Example for Free

Academic Papers Essay Academic papers are evaluated by professors to determine if a student can demonstrate extensive knowledge on a particular subject matter. Most professors require and grade students’ papers based on correct spelling and punctuation. They also expect a paper to contain no grammatical errors. An academic paper also demands that a student follow a certain format when writing the essay. Thus, a paper that comprises many errors can result in a lower grade that an individual expects or even deserves despite the fact that the content and research are excellent. However, due to time constraints and numerous workloads that a student handles on a daily basis details such as spelling, punctuation, format and grammatical errors becomes less of a concern. But these are the criteria that a paper is graded on. Therefore, these matters should not be overlooked. Application Papers An application paper is one of the most crucial aspects of applying to a university or college. This is because it contains information that reveals the insights, beliefs, values, goals, background and even upbringing of an individual. See more: Experiment on polytropic process Essay Therefore, universities clearly take it into consideration. It is important to have an application paper that is flawless. This means that spelling, punctuation and grammatical mistakes are not evident in the paper. This is because a well-written paper does not contain any of this. As a prospective student vying for a spot in the freshman class of a particular university, an outstanding application paper will definitely set you apart from other applicants. Therefore, a person should ensure that his or her application paper is presented in the best manner possible. Manuscripts/Articles Manuscripts are any printed work that you want to be published. Examples of manuscripts include official correspondence, legal and financial papers, technical briefs, poetries, editorials, reviews and case reports. Information about an organization or an individual is also considered a manuscript. They are usually used as a primary source. Therefore, accuracy and error-free work is highly valued. On the other hand, articles are usually a page or two of detailed information about a certain subject. Articles are written for a newspaper, magazine or a web site. Our editors will systematically look over any manuscripts and articles that you want to be reviewed. Therefore, the utmost quality of your work can be definitely achieved. Fiction Writing fiction can be time-consuming and a writer will mostly focus on conveying the appropriate word choice and making sure that ideas are flowing properly. Thus, at times a writer may neglect and fail to notice errors while writing and editing the fictional work at hand. Other times, writers feel that they cannot deliver or put into writing all the thoughts that are inside their mind. Also, writer’s block is experienced even by the best writers. Therefore, it is comforting to know that there is a service available that can assist fictional writers with any writing needs and styles that they want. Websites Webcontent writing is not an easy task to do. For an inexperienced writer, it can be daunting, challenging and downright terrifying. When you are setting up your website, you want to make sure that you hire a professional writer or service that will meet and even go beyond your needs. An exceptional service will demonstrate this by translating the company’s mission, vision and goals in a clear and error-free manner. A phenomenal service can certainly deliver information that will sustain the interest of site viewers, which will result in people coming back for more and numerous visitors flocking the site on a daily basis. Thus, it is vital to avail of a webcontent writing service that will ensure that your website will present easy to read information in a professional, comprehensible, simple and error-free manner. Speeches/Presentations Presenting information to a crowd of people is usually a nerve-wracking experience. You want to give a speech or presentation that is memorable, informative and captivating. At the same time, you want to make sure that you convey it in the right way, meaning the delivery of your speech or presentation lacks any possible errors. However, great speakers may not necessarily be the best writers around. Thus, it will be wise to utilize a service that can generate an unforgettable speech. This kind of speech will communicate a very lasting message that is highly entertaining, thought-provoking and direct to the point. Business Personal Letters Business letters are important because it is one of the quickest ways to develop rapport and persuade a potential client to avail of your company’s product or service. Therefore, a business letter should be polite, concise, straight-forward and error-free. A well-written business letter will instantly impress a potential client and will definitely present your company in the best way possible. Hence, a service that can provide business letters that are eloquent, personal and professional will definitely boost your company’s image and sales. On the contrary, personal letters reveal information about an influential or affluent person. Correspondence like this is kept by some academic institutions to give insights on the person’s life, activities and achievements. Personal letters are also found in some autobiographies. It is crucial to leave matters like these to the experts. Thus, a professional service can provide assistance and equip you with qualified editors at your finger tips. Formatting Formatting is a vital process in any written work. This is because it helps in organizing ideas clearly. It also presents information in a comprehensible way because ideas are easy to follow, which leads to an apparent understanding of the matter or topic being discussed. Formatting usually includes the size of a font, the type of font, indentation and margins used. It also consists of arranging and presenting information of several paragraphs in a unifying manner. Thus, without a proper and concrete format, any type of printed information will seem like a bunch of text that has to be deciphered in order to be understood. Editing/proofreading Editing, also known as proofreading, a written work is usually the final process of any writing endeavor or task. Editing is done to make sure that the work lacks error. Thus, editing will normally check spelling, punctuation and grammatical mistakes. Once a mistake has been detected, changes can be made to correct it before the work is published or submitted. It is an essential practice because people tend to overlook minor details and violate major writing rules. A well-conducted editing shows a well-constructed work. It also presents to the public a writer that is professional and eloquent. Therefore, it seems like any written work is not complete without undergoing this process. Editing Review Editing should be done by professional editors. Professional editors have years of experience. Therefore, reviewing any written work comes naturally to them. Also, their feedback will be valuable because they will automatically notice aspects of your writing that needs improvement or drastic change. Thus, they can best advice you on what steps to take to ensure that your writing can be enhanced. We cannot stress enough the importance of finding a service that will provide you with qualified and professional editors. This is because professional editors will aid you to have a finished paper that is above average, if not exceptionally done.

Liver Functions, Anatomy and Diseases

Liver Functions, Anatomy and Diseases Sandra Marais Nikita Wiggil Charne Scott Chante Wiese   Sue-May van der Westhuizen Stephanie Willows Contents (Jump to) Introduction The Anatomy and function of the Liver Definition and description of the disease Fatty Liver Disease Symptoms PATHOPHYSIOLOGY AND ETIOLOGY OF FATTY LIVER DISEASES: Treatment and prevention Introduction The Anatomy and function of the Liver Anatomy is the science of the structure and shape of entities. It is important for the knowledge of hepatic anatomy and surgery. The liver is one of the largest organs of the human body after the skin it is the second largest. The liver is the largest gland in the human body, with an average weight of 1500g. The transverse measurements ranges between 20 and 22,5cm, its vertical measurements (close to its right/lateral surface) between 15 and 17,5cm and its antero-posterior diameter between 10 and 12,5cm. Its measurement, from opposite the vertebral column, is reduced to roughly 7,5cm. It is found underneath the diaphragm -in the right upper abdomen, mid abdomen as well as in parts of the left upper abdomen. The shape of the liver generally has the form of a wedge or a prism. According to Synington the shape resembles that of a right-angled triangular prism with the right angle rounded off. Its base faces the right and its apex to the left, the colour of the liver is dark reddish brown it has a soft degree of density, it contains a large amount of vessels and is very brittle. In an adult, it is smaller than in a fetus. In the later (side) it contributes roughly one thirty-six of the body weight. In the former (side) it contributes roughly one-eighteenth of the body weight. The liver has three surfaces namely the superior (Facies superior), inferior (Facies inferior/ visceral surface) and posterior (Facies posterior). The posterior surface is divided from the superior surface by a sharp margin. The superior surface attaches itself to the diaphragm as well as the anterior abdominal by the falciform ligament (ligamentum falciform hepatis). The falciform ligament separates the liver into a right lobe (lobus hepatis dexter) and a left lobe (lobus hepatis sinister). The right lobe is larger than the left. Five fossae divide the inferior and posterior surfaces into four lobes. The fossae are arranged like the letter ‘’H’’. The left limb of the H is divided into what is known as the left sagittal fossa (fossa sagittalis sinistra/longitudinal fissure) consisting off the fossa of the umbilical vein and the fossa for the ductus venosus. The right limb of the H consists of the fossa for the gall-bladder (fossa vesicà ¦ felleà ¦) and th e fossa for the inferior vena cava (fossa venà ¦ cavà ¦). The two limbs of the H surfs as a transverse fissure- the porta (porta hepatis/transverse fissure). The superior surface is part of is part of the left and right lobe. This surface is convex. The middle part is found behind the xiphoid process and it makes contact with the abdominal wall. It is entirely concealed by peritoneum, with the exception of the line of attachment of the flaciform ligament. The inferior surface is concave. It is aimed downward, backward as well as to the left. The surface is infused in peritoneum- the only parts that are without it, is where the gall-bladder and the liver attaches as well as at the porta hepatis. The posterior surface has a curved surface and is broad on the right, but narrow on the left. The diaphragm is attached with a triangular and coronary ligament that intertwine connective tissue, it leads to the intimate connection of the inferior vene cava that is connected with hapatic veins that holds up the posterior part of the liver. The abdominal viscera full the abdomen, where the muscular walls are in a state of tonic contraction. The superior surface of the liver fits under the diaphragm surface, so that the pressure is enough to hold the diaphragm. The lax falciform ligament creates no support for the lateral displacement and the latter creates negative pressure that is held up in the thorax (Gray, Henry. Anatomy of the Human Body. PHILADELPHIA: Lea Febiger, 1918; Bartleby.com, 2000. www.bartleby.com/107/. [DATE of Printout].) Functions of the liver The liver receives blood from two main sources: 30% is received from the hepatic arteries and 70% is received from the hepatic portal vein. The hepatic portal vein receives blood from the stomach, intestines, pancreas and spleen; which is then carried to the liver through the porta hepatis. All nutrients are absorbed by the small intestine, all nutrients reaches the liver by this route except for lipids. Arterial blood bound for the liver exists the aorta ant the celiac trunk. These arteries deliver oxygen and other materials to the liver. (SALADIN, p. 975-977) Digestion Liver produces bile; which is a mixture of water, bile salts, cholesterol and pigments of bilirubin. Bile is produced by hepatocytes in the liver. Bile passes through the bile ducts and is stored in the gallbladder. Fats are emulsificated by bile. Large fat clumps are turned into smaller pieces which makes it easy for the body to digest. Old worn oud red blood cells are destroyed by Kupffer cells in the liver. Kupffer cells pass their components to the hepatocytes. Haemoglobin is the red oxygen-carrying pigment of red blood cells, haemoglobin is metabolized into heme and globin components. Energy for the body comes from globin protein. Metabolism Liver is responsible for metabolizing carbohydrates , lipids and proteins into biologically useful materials. Blood entering the liver through the hepatic portal vein is rich in glucose from digested food. Some of this glucose is absorbed by hepatocytes. The glucose is stored as the macromolecule glycogen. Homeostasis is maintained by the absorption and release of glucose by the hepatocytes, it helps protect the body from spikes and drops that can be dangerous in the blood glucose level. Hepatocytes absorb and metabolise fatty acids to produce energy in the form of ATP. Through gluconeogenesis the hepatocytes convert glycerol and other lipid components into glucose. Cholesterol is a lipid which can also be produced by hepatocytes and gets excreted from the body as a component of bile. Amino acids is a component from dietary proteins. Amine groups are removed from the amino acids, by the hepatocytes, which is further converted into ammonia and urea. Urea can be excreted in urine as a waste product. Urea is less toxic than ammonia. Detoxification Hepatocytes cells of the liver monitor the contents of the blood and toxic substances are removed before they reach the rest of the body. Alcohol and drugs are metabolised into their inactive metabolites by the enzymes in hepatocytes cells. Storage Nutrients, vitamins and minerals obtained from the blood passing through the hepatic portal system are stored in the liver. Homeostasis of blood glucose is maintained by the storage of nutrients. Vitamins such as A, D, E, K and B12 is stored in the liver. Minerals such as iron and copper are stored in the liver. Production Vital protein components of blood plasma such as prothrombin, fibrinogen and albumins are produced by the liver. Prothrombin and fibrinogen proteins are factors involved in the formation of blood clots. Albumins maintain the isotonic environment of blood. Immunity Bacteria, fungi, parasites, worn out red blood cells and cellular debris are captured and digest by Kupffer cells. Large volumes of blood are cleaned very quickly by Kupffer cells due to the large volumes of blood passing through the hepatic portal system. (www.innerbody.com/image _digeov/card10-new2.html) American journal of Physiology: Gastrointestinal and Liver Physiology : physiology and pathophysiology of apoptosis in epithelial cells of the liver; pancreas and intestine. By Blake. A. Jones ; Gregory. J. Gores. Published 1 December 1997 (vol.273. no.6, G1174-G1188) Definition and description of the disease Fatty liver disease â€Å"Non-alcoholic fatty liver disease (NAFLD) is a clinical and pathological syndrome.† (Zeng, et al., 2008) The main feature of NAFLD is the swelling of the (liver cells) hepatocytes because of pathological factor, alcohol excluded, that injure the liver. NAFLD is ranged from fatty liver alone to steatohepatitis, steatonecrosis and non-alcoholic steatohepartitis (NASH). (NASH) is only a stage in non-alcoholic fatty liver disease. NAFLD may have the potential to progress into cirrhosis and liver failure.† Liver –biopsy features include steatosis, mixed inflammatory cell-infiltration, hepatocytes ballooning and necrosis, glycogen nuclei, Mallory’s hyaline and fibrosis.† (Angulo, 2002) According to Jansen (2004) NASH is an under diagnosed liver disease characterized by steatosis, necroinflammation and fibrosis. NASH can possibly develop into cirrhosis and hepatic cellular carcinoma. NASH incorporate mixed acute and chronic lobular inflammation, zone 3 perisinusiodal fibrosis and ballooning (Brunt, et al., 1999). Alcoholic liver disease. Alcoholic liver disease (ALD) includes a variety of spectrum of injury that can be from simple steatosis to frank cirrhosis. There are 3 groups of histological stages of ADL. Fatty liver or simple steatosis, alcoholic hepatitis and chronic hepatitis with hepatic fibrosis or cirrhosis. ALD can be caused by different types of factors including dose, duration and type of alcohol consumption and risk factors like obesity iron overload ect. Fatty Liver Disease Symptoms Non-alcoholic fatty liver disease causes no signs or symptoms that can be noticed but when it is noticed, it show signs of: Fatigue Pain in the right upper abdomen Weight loss. Inflammation and scarring of the liver Possible progression to liver failure. Symptoms consists of four (4) stages namely Simple fatty liver disease ( steatosis), Non-alcoholic Fatty liver Disease (NAFLD), Fibrosis And Cirrhosis. Simple fatty liver (Steatosis)- There are no clear symptoms and it can only be discoverd by an abnormal blood test result. Non-alcoholic Steotohepatitis (NASH)- It is the most aggressive form of this condition, it causes the liver to become inflamed creating a dull or aching pain in the top right abdomen, covering the lower side of the ribs. There may be no signs of any symptoms at all and it can only be discovered by specialized testing. Fibrosis- Constant inflammation in the liver which leads to the formation of scar tissue. Cirrhosis- Over a long period of time, it creates inflammation which can lead to the loss of liver function- which may lead to creating primary cancer. ALCOHOL-RELATED (ARLD) It shows no symptoms until the liver has already been severely damaged and it causes symptoms such as: Feeling sick, weak or tired Loos of weight Loss of appetite Jaundice- the yellowing of the eyes and skin The swelling of the stomach and ankles Confusion or drowsiness The excretion or the vomiting of blood. Alcohol related fatty liver disease is constantly diagnosed because of other conditions or other tests. PATHOPHYSIOLOGY AND ETIOLOGY OF FATTY LIVER DISEASES: Fatty Liver Disease encompasses two over head segments, namely Alcoholic Liver Disease and Non Alcoholic Liver Disease. ALCOHOLIC LIVER DISEASE (ALD) Alcoholic Liver Disease (ALD) encompasses the manifestations of the liver that is caused by the over consumption of alcohol (ethanol). It includes Fatty Liver, Alcoholic Hepatitis, and Chronic Hepatitis with liver cell fibrosis or cirrhosis.*1 Ethanol metabolization takes place in the liver. There are two main pathways of alcohol metabolism, namely alcohol dehydrogenase and cytochrome P-450 (CYP) 2 E1. The first pathway works as follows: Firstly ethanol is metabolized by Alcohol dehydrogenase (ADH) into Acetaldehyde in the cytoplasm. The second phase occurs in the smooth Endoplasmic reticulum of mitochondria, where Acetaldehyde is further metabolized by Aldehyde dehydrogenase into acetate. Acetate is then finally oxidized into carbon dioxide (CO2) and water. CYP 2E1 also converts ethanol into acetaldehyde (OShea, et al., 2010). Liver damage occurs in a few mutually related pathways: Acetaldehyde can form hybrid-adducts with reactive residues acting on proteins or small molecules, mediating lipid peroxidation and nucleic acid oxidation. (French, et al., 1984) During further metabolization of alcohol, Nicotinamide Adenine Dinucleotide (NAD) is reduced. This causes a shift in the NADH/NAD ratio. A higher NADH (reduced form of NAD) concentration increases the production of fatty acids, while lower concentrations of NAD result in decreased fatty acid oxidation. This altered ratio impair the metabolization of carbohydrates and lipids, resulting in the diversion from gluconeogenesis to ketogenesis and fatty acid synthesis. The liver cells compound the fatty acids to glycerol to form triglycerides. These accumulating triglycerides result in fatty liver. This leads to oxidative stress, which plays a pivotal role in ALD development. (French, et al., 1984) Furthermore, Acetaldehyde interacts through covalent binding with reactive residues of proteins found on the membranes of liver cells. This binding results in the formation of stable protein by-products which have been shown to be immunogenic. Tissue damage and ALD may be caused by this, because the neo-antigens may induce an immune reaction with anti-body production. CYP 2 E 1, when exposed to chronicle alcohol use generates free radicals through the oxidation of Nicotinamide Adenine Dinucleotide phosphate (NADPH) to NADP (OShea, et al., 2010). This exposure activates hepatic macrophages, also known as Kupffer cells, which leads to Tumor Necrosis factor-alpha (TNF-alpha). The production of reactive oxygen species (ROS) is increased by the mitochondria, which in turn was induced by the TNF-alpha. This also promotes oxidative stress, which leads to hepatocytes necrosis and apoptosis. Many alcoholics have a condition of malnutrition. The deficiency in anti-oxidants, such as vitamin E, only worsens the necrosis and apoptosis. Free radicals initiate the oxidative degradation of lipids, which causes inflammation and liver tissue becomes scarred. Although the over consumption of alcohol is the primary cause of ADL, it is not always a pre-requirement for ALD development. It is important to understand the mechanisms of liver damage. When liver cells are exposed to alcohol, ATP synthesis is reduced and the activity of mitochondrial complexes is depressed. This causes energy metabolism of liver cells to be severely weaker and results in tissue damage. Metabolization of ethanol takes place in the centrilobular area of the liver lobule. Hypoxia alters energy metabolism, therefore centrilobular hypoxia can also be responsible for liver injury. The pathophysiology of alcoholic liver disease is very complex and further in depth investigation to understand the disease and how to treat it is being done. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) Non-Alcoholic Fatty Liver Disease is an over arching term for a variety of conditions associated with fat depositions in liver cells. NAFLD ranges from Simple fatty liver to nonalcoholic steatohepatitis (NASH), to fibrosis and cirrhosis. The first stage of NAFDL is simple fatty liver or steatosis. It is considered harmless and only consists of a fat build up in the liver. The second stage, Nonalcoholic steatohepatitis is more serious, but not many individuals progress to this state from simple fatty liver. Two liver insults may lead to the development of NASH. With the first insult or hit, macro-vesicular steatosis (abnormal retention of lipids within a cell) occurs as a result of an excessive amount of triglycerides accumulating in the liver. The cause of triglyceride accumulation can result from excessive importation of free fatty acids from adipose tissue.*5 The accumulating lipids in the liver cells seem to be caused by insulin resistance. Insulin resistance leads to changes in the livers enzymatic pathways that control free fatty acid uptake, synthesis, degradation and the secretion of free fatty acids. A crucial paradox arises: the liver maintains its liver lipid metabolization, but carbohydrate metabolism is weakened or damaged. Hepatic steatosis caused by these factors can result into diminished hepatic free fatty acid oxidation, more hepatic lipogenesis or fewer lipids are secreted from the liver. Along with insulin resistance, obesity plays an important role in the development of NAFLD. These alterations make the liver sensitive for the second insult or hit, which is an inflammatory response and further liver damage (Carey, et al., 2013). Toxic inflammatory proteins are secreted by the cytokines in the liver.*6 Hepatocyte apoptosis, an organized form of cellular death, is a leading component of the second insult of NAFLD progression. Oxidative stress and resulting lipid peroxidation are involved in the progression of NAFLD to NASH. The term â€Å"oxidative stress† is frequently used to describe the imbalances in redox couples. *7 This metabolic reaction produce too much reactive free radicals called reactive oxygen species (ROS). This process usually occurs in the mitochondria. Lipid peroxidation can lead to changes in the cell membrane fluidity and these alterations cause tissue damage. Fibrosis is the third stage of NAFLD. NASH develops to form fibrosis if it is not treated. Fibrosis occurs where chronicle inflammation in the liver results in the formation of fibrous scar tissue around hepatic cells and blood vessels. The liver still functions normally, because there is still enough healthy tissue. The forth and most severe stage of NAFLD is cirrhosis. During this stage lots of scar tissue develops. This causes the liver to shrink and change morphologically. The damage caused by cirrhosis is permanent and cannot be saved or reversed. The progression of cirrhosis is slow, but it ultimately causes the liver to stop functioning.*8 Treatment and prevention Basic therapy: you have to work out a strategic plan of the intake of calories and adjustment of diet constitution. Medium aerobic exercise and the changing of some life styles and behaviour. Weight reduction: The most important fact of weigh reduction is not the amount of weight loss but how the weight is lost. Losing weight rapidly may increase portal inflammation and fibrosis. A relatively safe goal is to lose about 1.6kg per week. Liver transplantation: For some patients liver transplantation is recommended. Metabolic states should be examined before the transplantation. A BMI >40kg lm2 is a contrain dication (Zeng, et al., 2008) Abstinence: This is a very important therapeutic intervention for patients that have ALD. Abstinence helps to decrease portal pressure and lower progression to cirrhosis.