Acute non-B hepatitis cases observed in JAPAN were subjected for serologic examination for hepatitis A, and serum samples obtained in 1971 from healthy individuals living in the ara surrounding Tokyo and human immunoglobulin in preparations produced in JAPAN in 1975 and 1976 were examined for antibody to hepatitis A antigen. From non-B hepatitis cases a total of 11 sporadic cases and 33 outbreak-associated cases were confirmed as hepatitis A, but including all of 13 transfusion-associated non-B hepatitis cases many sporadic cases were not confirmed as hepatitis A. The antibody prevalence to hepatitis A found in healthy individuals strongly related to age. The rates of antibody positives in groups younger than 20 years of age were 2.5%. The rates rapidly increased in the age-groups of twenties and thirties and stayed arround 70% in groups older than 40 years of age. Human immunoglobulin preparations were found to contain an ample amount of antibody to hepatitis A antigen. These results indicated the possibilities that not only hepatitis A and B viruses but also non-A non-B hepatitis virus(es) are existing in JAPAN, and that the infection with hepatitis A virus was not popular during at least these 20 years.

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Among acute B hepatitis which we have treated during the latest year, we have investigated the relation especially between the pattern of an appearance of HBe antigen and its clinical progress from 12 cases about which we could examine information of hepatitis B virus from an early stage.
The 6 patients of them were belonging for medical work, therefore we could start to observe their progress from the point when their HBs antigen had turned to positive. We realized HBe antigen appeared transiently in 4 out of 6 patients. The appearances of HBe antigen in these 4 cases turned up when the titer of HBs antigen in serum was at a peak period besides this titer was over 210. Comparing these 4 cases with the other 2 ones in which we could not find the appearance of HBe antigen, the duration of those 4 patiens' HBs antigen in serum was longer and also their symptoms and liver fanctiontests were severer than the others'.
On the other hand, the other 6 patients came to hospital after they had become acute hepatic illness. Among these 6, we found only one transient appearance of HBe antigen. This patient got post-transfusions hepatitis and the titer of HBs antigen in serum was 210 at the first examination. The other 5 patients' titer of HBs antigen in serum at the first examination was under 210.
There were no different prognosis even if HBe antigen appeared or not and all the 12 patients recovered with satisfactory clinical progress.
From our experience, we would think an appearance of HBe antigen in acute B hepatitis cannot always be a characteristic marker of prognosis.

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A survey of hepatitis type B infection was performed on sixteen familiies, each of which included at least one patient with acute type B viral hepatitis admitted to Gifu Prefectural Gifu Hospital from July 1975 to July 1977. We examined their sera for HBsAg, anti -HBs, HBeAg, anti -HBe, anti -HBc and subtype more than two times. The examination was made within one week of admission of the index cases, and again at least four weeks there after. The families under the investigation consisted of one couple without offsprings and fifteen couples, each living with their offsprings. None of the spouses of the index was a HBsAg chronic carrier, but five of the married couples had suffered from acute hepatitis B about four months after the onset of the illness of the index spouse. On the other hand, among twenty eight children of fifteen families, thirteen children (46%) of twelve families (80%) were at the first examination HBsAg, HBeAg and anti-HBc (high titer of 2, IAHA) positive.
Their age was between one year three months and six years old, especially eleven of the thirteen children with HBsAg were younger than three years old. Besides, all of them were found to be chronic HBsAg carriers. In all the families, the subtype of the index cases was the same as that of their HBsAg positive children. The subtype was adw except one case of adr. In this study the majority of patients with adult acut hepatits B are suspected to be infected from their HBsAg carrier son and/or daughter who had been infected perhaps in a hospital by parenteral route.

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Twenty three Japanese patients with chronic active hepatitis were HLA typed by Terasaki's microcytotoxicity technique. There was no significant association between particular HLA specificities and chronic active hepatitis, regardless of the presence or absence of HBs antigen. it was found that the frequency of HLA-A9, Bw35 haplotype, which was reported to have strong association with autoimmune thyroiditis, was higher in 8 patients with active chronic hepatitis (i.e. 3 cases of chronic active hepatitis associated with Sjogren syndrome, 1 with Hashimoto's disease and 4 with positive LE test and antinuclear antibody in the serum), than in 138 healthy controls. The present study suggests that a close association between Japanese active chronic hepatitis and the specific haplotype of HLA may be present.

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HBsAg, HBsAb, some kinds of autoantibody and anti-liver cell membrane antibody (ALMA) were estimated in 105 cases of chronic hepatitis and cirrhosis, and their sexual differences were examined. Same studies were also focused to lupoid type of chrpnic aggressive hepatitis (Sherlock).
The incidence of autoantibodies did not correlate with the occurrence of HBsAg at all. ALMA was detected more frequently (p<0.01) in autoantibody positive patients. In chronic active hepatitis, although the incidence of HBsAg was significantly higher in male (p<0.05), HBsAg, anti-nuclear antibody, anti-smooth muscle antibody (p<0.05) and ALMA were detected more frequently in female.
These results may suggest that there is a sexual difference in appearance of abnormal antibody responses in chronic hepatitis, and the immunological characteristics in lupoid type of chronic aggressive hepatitis (Sherlock) are easily understood on the view of sexual difference.

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Pancreozymin-secretin test and glucose tolerance test were performed in 101 patients with chronic liver diseases. Responses of serum insulin and plasma glucagon to glucose or arginine load were also studied in some cases of them.
Mild pancreatic exocrine insufficiency was found in 35% of all subjects, but these cases showed no different glucose tolerance and pancreatic endocrine function from those which healthy controls did. Moderate to severe insufficiency was observed in 11% of non-cirrhotic cases and in 6% of cirrhotic cases, and most of them were alcoholics. In these cases glucose intolerance or pancreatic endocrine insufficiency were more often found than mild exocrine insufficient cases.
These results suggest that pancreatic disorder dose not influence on glucose tolerance in all cases with chronic liver diseases, but in non-cirrhotic alcoholics it has important roles. So, in such cases pancreatic exocrine and endocrine function must be studied to determine whether concomitant pancreatic disorder results in glucose intolerance.

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Occurrence of orcein-positive granular substances in the hepatocytes of PBC livers of 26 cases was examined in each stage of PBC. These substances showed no peculiar localization within the hepatic lobules in early stage, but their distribution tended to be confined to the peripheral portions of the lobules or regenerative nodules after middle stage. There was a tendency to be increasing in degree of distribution of these substances in peripheral portions and amounts of these substances in the hepatocytes with progression of the stage of PBC. These evidences suggested that occurrence of these substances was partly dependent upon progression of the stage of PBC.

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A sensitive, specific and conventional enzyme immunoassay (EIA) for the measurement of ursodeoxycholic acid (UDCA) in human serum was described. Anti-UDCA serum was raised in rabbit using UDCA-bovine serum albumin conjugate as antigen. UDCA-alkaline phosphatase(calf intestine) conjugate prepared by a method of carbodilmide was used as a tracer. The assay was carried out by the two antibody method, and alkallne phosphatase activity of bound complex was measured by King-King method. The ratio of bound to total enzyme activity decreased linearly with a logarithmic increase in ursodeoxycholic acid concentration from 20 to 900p moles.
The specificity and sensitivity of this EIA were similar to those of RIA reported previously. The serum UDCA concentrations measured by this EIA were highly correlated with those by gaschromatography or RIA.
It is concluded that this UDCA-EIA system is a useful tool for routine analysis of serum bile acids in the clinical fields.

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In female rats pretreated with 0.5mg per 100gm body weight of ethynyl estradiol for seven days, bile flow reduced to 27% of control rats, associated with 24% decrease of bile acid excretion into bile. Reversed correlation was found between a given dose of the ethynyl estradiol and bile flow as well as bile acid excretion. Although continuous infusion of 0.6μM/100gm body weight/min. of taurolithocholate (TLCA) into the femoral vein of rats induced cholestasis, bile flow was increased when 0.083μM/100gm body weight/min. of TLCA was given. However, in rats pretreated with above mentioned dose of ethynyl estradiol, the bile flow was reduced to 52% of nonpretreated control rats with elevation of serum bilirubin by infusion of 0.083μM/100gm body weight/min. of TLCA. Those data suggest that small dose of TLCA, which is not enough for inducing cholestasis, can cause cholestasis when rats are predisposed to it.

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Using computed tomography, the cross-sectional anatomy of the normal liver was studied with regard to the segmentation of the liver based on vascular distribution.
The recognition of the left sagittal, right anterior and posterior fissures which are clearly demonstrated on computed tomograms is very important to proceed the diagnosis of hepatic mass lesions based on the segmentation of the liver. Initial data of our clinical studies indeed indicate that computed tomography is essential to determine the cutting zones of hepatic mass lesions for hepatic surgery, it seems, however, less helpful in screening out the primary liver cancer, especially hepatocellular carcinomas, because radiological information obtained by our presently available computed tomography unit, ACTA 0100, is often decreased by motion artifact, and because contrast enhancement using Meglumine Diatorizoate is less effective in cases with hepatocellular carcinoma. The reason why contrast enhancement is not actually so effective as has been expected in delineating hepatocellular carcinomas was also discussed.

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