In 2020, a new concept of fatty liver disease, metabolic dysfunction-associated fatty liver disease (MAFLD), has been suggested by the International Expert Panel consisting of 32 specialists from 22 countries. MAFLD is fatty liver coexisting with "obesity," "type 2 diabetes," or "two or more metabolic disorders." Metabolic abnormalities are key risk factors for the advancement of fatty liver disease, and MAFLD appears to be beneficial in identifying people at high risk. I outlined the properties of MAFLD herein. I also discussed the link between MAFLD and liver-related and extrahepatic events such as atherosclerotic cardiovascular disease and extrahepatic cancers. In addition, I discuss the impact of MAFLD on fatty liver disease awareness, disputes, and future developments in fatty liver nomenclature.

This research analyzed whether the same liver stiffness (LS) evaluated by magnetic resonance elastography (MRE) could predict portal hypertension in 718 patients with chronic liver disease (CLD) of multiple etiologies. In CLD, platelet counts decreased from LS ≥ 4 kPa for all causes, and the complication rate of varices increased dramatically. In advanced CLD (ACLD), LS ≥ 6 kPa was independently related to the development of ascites in synchrony with worsening hepatic reserve, and ascites were an independent prognostic factor for ACLD. For all causes, this study shows that MRE is useful for risk evaluation and treatment decisions for portal hypertension.

The patient is a 71-year-old man. Lamivudine 100 mg was given at another hospital for chronic hepatitis B. Later, adefovir pivoxil (ADV) 10 mg was added due to an increase in HBV DNA level. He caused Fanconi syndrome, which is thought to be caused by ADV. Then entecavir (ETV) monotherapy was introduced. He was then referred to our hospital due to elevated HBV DNA levels and severe hepatitis. As a result, ETV was replaced by tenofovir alafenamide (TAF). Four years later, he was hospitalized due to fatigue and his inability to take it orally. An arterial blood gas test revealed pH 7.32 and HCO₃- 7.5 mmol/L. He was diagnosed with metabolic acidosis. Furthermore, urinary 2-microglobulin levels increased significantly, and renal tubular dysfunction was identified, indicating a return of Fanconi syndrome.

We report a sister and brother with Caroli's disease. Case 1, a 23-year-old brother, was diagnosed with Caroli's disease after a close examination conducted due to pancytopenia and splenomegaly revealed intrahepatic bile ducts with cystic dilatation, multiple renal cysts, and esophageal varices. In case 2, a 32-year-old sister was found to have intrahepatic bile duct dilatation and several renal cysts, as did her brother, after esophageal varices ruptured, leading to the diagnosis of Caroli's disease. Case 1 repeated complications such as cholangitis and esophageal varices rupture, and developed noncompensated cirrhosis. Chronic renal failure caused by autosomal-recessive polycystic kidney disease deteriorated over time, eventually requiring hemodialysis. Since complications of Caroli's disease can lead to severe outcomes, it is necessary to perform a thorough search of family members at the time of diagnosis in addition to the patient to ensure early discovery of the disease.

Partial splenic embolization (PSE) through radial artery utilizing 5 Fr. 125 cm catheter and 1.9 Fr. 150 cm or 1.7 Fr. 165 cm microcatheter has been conducted in six liver cirrhosis patients with splenomegaly. After inserting the catheters into the splenic artery, gelatin sponge particle and/or pushable coil embolization was performed in splenic peripheral branches. After removing the sheath, a compression wristband was utilized to stem the bleeding in the radial punctuated region. Patients were able to move immediately following the treatment and did not require any bed rest. In all, 65%-80% of the spleen's volume was embolized effectively, and no adverse events occurred during the procedure. Our data demonstrated radial technique could bring safe and satisfactory results for PSE with less discomfort for the patients after the method.