The specificity of insoluble liver cell membarne antigen (LMAg) different from liver specific lipoprotein (LSP), was investigated by immunodiffusion using 2% polyethylene glycol (PEG-ID), immunofluorescence technique and enzyme-linked immunosorbent assay (ELISA). Serum anti-LM against acetone-fixed rat liver was detected in 9 of 13 patients with anti-HBs-positive chronic liver diseases (CLD) and 10 of 25 healthy persons with positive anti-HBs by immunofluorescence technique. Results of ELISA indicated that sera of 21 patients with lupoid hepatitis from Intractable Liver Diseases Committee, the Ministry of Health & Welfare, Japan and 25 patients with HBsAg-negative CLD had high levels of anti-LM. In immunohistological demonstrations of LMAg and LSP, the anti-LM prepared from an anti-HBs-positive patient with chronic active hepatitis bound to each of the human and rat acetone-fixed liver cell membranes, but not bind to any of human and rat kidney tissues. The absorbed rabbit anti-rat LM also bound to liver cell membranes, but the absorbed anti-rat LSP lacked organ-specificity to acetone-fixed liver tissues. Results of PEG-ID indicated that the absorbed rabbit antirat LM had precipitated to two organ-specific components of rat liver homogenate, and one of the two was identified as the one of the absorbed anti-LSP.
In conclusion, it is indicated that the appearance of serum anti-LM is associated with a host immune response against the surface antigen components on hepatitis B virus (HBV).

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In vitro immunoglobulin production by peripheral blood lymphocytes (PBL) from children with acute leukemia (N=41) and their responsiveness to mitogens were evaluated by the Enzyme-Linked Immunosorbent Assay (ELISA), using microtitration plates as a solid-phase immunosorbent. PBL (1×10⁶/ml) were cultured at 37°C for 7 days in a 5% CO₂ incubator in (RPMI 1640) medium supplemented with 10% fetal calf serum, in the absence or presence of mitogen stimulation. As mitogens, pokeweed mitogen (PWM) and Staphylococcus aureus strains Cowan I (SpA Co I) were used. Applying a personal computer, MZ-2000 (SHARP), and model equations, ELISA's standard curves were computed, and Ig concentration in the PBL culture supernatants were calculated from absorbance of the samples measured by ELISA. For analysis ofthe data, patients were divided into two groups: group 1 consisted of those under remissionmaintenance therapy and group 2 those under off-therapy. Under the mitogen-unstimulated condition, IgG production by PBL from children with leukemia (ALL and AML) was, as compared in the mean value, almost equal to that by PBL from control children (N=12). IgA and IgM production, not only in group 1 but also in group 2, were less than the respectivecontrol values. Under the PWM-stimulated condition, amounts of Ig production in group 1 were, in all Ig classes, much less than those in control children. Amounts of Ig production in group 2 were more than those in group 1, but less than those in control children. The responsiveness of PBL to PWM was evaluated by the stimulation index: the index=lg production under PWM-stimulated condition/Ig production under mitogen-unstimulated condition. In allIg classes, the responsiveness to PWM was lower in group 1, but was equal to the controlvalue in group 2. Similar results were obtained with the PBL stimulation by SpA Co I.
Our ELISA can detect small amounts of Ig in PBL culture supernatants. The application of ELISA and a personal computer is useful for the accurate and rapid measurement of Ig in many samples.

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Autoantibodies against thyroid organ specific membrane antigens were studied using complement fixing test, double immunodiffusion, fluorescent antibody technique (FAT), cytotoxic test and antibodydependent cell-midiated cytotoxicity (ADCC) assay.
In complement fixing test, the antibody against thyroid microsome fraction and the antibody against plasma membrane strongly fixed complement but the antibody against thyroglobulin poorly fixed compelment.
Using double immunodiffusion, the anti-membrane antibody could be detected by the use of the solubilized membrane fractions.
Precipitin lines of Hashimoto sera and Graves sera with the solubilized thyroid microsome fraction fused in complete immunological identity.
Precipitin lines of both microsome and plasma membrane fractions with patients' sera also fused in a complete immunological identity. The serum of rat (Rt) immunized with solubilized thyroid microsome fraction had an antibody compatible with the human autoantibody against thyroid membranes.
The antibodies against plasma membrane could be detected by FAT in sera of patients who had high titers of microsome hemagglutination (MCHA). The inhibition test using FAT revealed that the cytoplasmic staining was not interfered by the pretreatment with Rt but the cell surface staining was abolished by the pretreatment with Rt. The antibody against plasma membrane that was eluted by the use of dispersed thyroid cells compatible with antigens recognized by anti-microsome antibody.
⁸⁶Rb was employed to detect the cytotoxic activity of sera of patients with autoimmune thyroid disease. The high titers of cytotoxic activity were observed in sera of patients with Hashimoto's disease or Graves' disease that had high titer of MCHA.
⁵¹Cr was employed to detect ADCC. The activities of ADCC could be detected in sera of Hashimoto's disease or Graves' disease that had high titer of MCHA.
Those results revealed that: 1) Anti-microsome antibody was identical with anti-plasma membrane antibody. 2) Anti-microsome antibodies observed in sera of patients with Hashimoto's disease were identical with those in sera of patients with Graves' disease. 3) Antimicrosome antibodies of patients with Graves' disease also had the activities of direct cytotoxicity and ADCC against dispersed thyroid cells.

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A remarkable therapeutic effect of repeated plasma exchange was observed in one patient with steroid resistant systemic lupus erythematosus who had postpartum exacerbation of disease activity and major side effects of corticosteroid.
The patient was a 31-year-old house wife in puerperium, who was diagnosed as a systemic lupus erythematosus on the basis of butterfly rash, photosensitivity, arthritis, oral ulcers, leukocytopenia, lymphocytopenia, LE cells phenomenon, positive fluorescent anti-nuclear antibody and anti-DNA antibody. At the seventh week after delivery, the disease activity was acutely exacerbated. Although she was treated with increasing dosis, up to 90mg per day, of corticosteroid, the severity of the activity remained unchanged and in addition, the major side effects of the steroid developed. A total of four plasma exchanges of 2.0 litters each was done and resulted in disappearance of high fever, improved lupus symptoms, reduction of circulating immune complexes measured by both polyethylen glycol precipitation method and ¹²⁵I-Protein A binding method, and improvement of T cell function assessed by lymphocyte blastogenesis induced by PHA and Con A.
It was suggested that plasma exchange may be useful not only in the patient who showed exacerbation of SLE activity following delivery, but also in the patients who have undesired highlevels of circulating immune complexes and impaired T cell function and who are not responsive to even high doses of corticosteroid or have major side effects of corticosteroid.

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