Ten patients with chronic hepatitis B were treated with interferon (IFN). Changes of the binding of human lymphoblastoid interferon (HLBI) to PBMC and the induction of 2'-5' oligoadenylate synthetase (2-5 AS) in peripheral blood mononuclear cells (PBMC) were determined during IFNtreatment. The mean pretreatment binding of HLBI to PBMC of patients was similar to normal individuals. The binding of HLBI remained unchanged until 10 to 14 days after the first injection of IFN, since then it decreased to 40 to 60 percent of the pretreatment value. 2-5 AS was induced when PBMC was cultured with IFN in vitro before IFN treatment. However, during the treatment, the level of 2-5 AS in PBMC decreased when PBMC was cultured even in the presence of IFN. On the other hand, 2-5 AS remained at a high level during the treatment in vivo. This phenomenon couldn't be accounted for by change in the binding of HLBI to PBMC. IFN administration might induce a new mechanism to maintain high levels of 2-5 AS in vivo.

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Responses of peripheral mononuclear cells and T cells from patients with chronic hepatitis (CH) type B to recombinant interleukin-2 (rIL-2) were examined. Changes of viral and immunological markers following intravenous administration of rIL-2 against patients with CH type B were examined simultaneously. Mononuclear cells and T cells from patients with CH type B responded to rIL-2 in the same degree as those from normal controls. Immediately after intravenous drip infusion of rIL-2, the number of peripheral lymphocytes and Leu11+ cells decreased significantly in the all 7 patients with CH type B. NK activity decreased significantly in 5 of 7 patients with CH type B, and the OKT4/OKT8 ratio increased significantly in the all 7 patients with CH type B. In 6 of 9 patients to whom rIL-2 was administered for 7 or 28 days, the activity of DNA-polymerase decreased during treatment.
It was considered that in vivo effect of IL-2 on patients with CH type B is attributed to an antiviral action through hitherto unexplained immunological affairs.

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To investigate the effect of steroid hormon on infection pattern of Duck Hepatitis B Virus (DHBV), experimental transmission of DHBV was purformed using 80 Japanese white Pekin ducks with andwithout administration of hydrocortisone. Admininstration of the steroid hormon elongated the duration of viremia of DHBV and increased the amount of DHBV-DNA in the sera of ducks inoculated with DHBV both on day 7 and on day 14 posthatch. There was no significant difference in histologicalfindings between ducks with and without administration of the steroid hormon. Ducks inoculated with DHBV on day 7 posthatch showed low level of DNA polymerase activity in spite of high level of DNA in the sera by administration of the steroid hormon and this discrepancy was not observed in those inoculated on day 14 posthatch.

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The present study aimed to elucidate the presence of fibrogenic factor to the hepatocyte in the plasma of fulminant hepatitis patients and to evaluate the role of hepatocytes on the hepatic fibrosis by using primary cultured hepatocytes of rat. The isolated hepatocytes were cultured with William's medium E containing 10% plasma from the patient with fulminant hepatitis. Fiber formation was obserbed around the hepatocyte in as little as 6 hours and gradually increased in amount by light and electron microscopic observations. These fiber showed to have typical cross-striation in diameter of 120nm and were stained with Mallory-Azan, silver impregnation and anti type III collagen antibodies. 3H-proline grains were distributed on the fibers and the rough endoplasmic reticulm of the hepatocyte by autoradiographic study. It is suggested that the fibrogenic factor accelerating the hepatocyte to synthesize collagen is present in the plasma from patients with fulminant hepatitis.

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The effects of ethanol on hepatocytic regeneration were studied in rats. With acute administration of ethanol, DNA synthesis and commencement of the S phase of the cell cycle in hepatocytes after partial hepatectomy were delayed. For chronic ethanol administration, DNA synthesis after partial hepatectomy was clearly reduced and commencement of the S phase was retarded. These results indicate that both acute and chronic administrations of ethanol inhibit hepatocytic regeneration.

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Aclinical and pathological study on chronic alcoholic patients showing acllte hepatic failure due to alcoholic liver disease without liver cirrhosis was performed.
The patients consisted of five male and one female. The mean (±S.D.) age was 46.1±8.7 years, total consumption of ethanol 810±550kg, and the average daily consumption of ethanol 143±33 g per day. All patients revealed an increase in consumption of ethanol and a poor dietary intake for from 5 days to four weeks before admission. Serum HBs antigen was negative in all cases. Icterus was seen in all patients, and ascites in five cases, Four patients showed deep hepatic coma (grade V) and three of the four patients died. The other two patients revealed moderate hepatic coma (grade II) and recovered. Liver specimens showed numerous Mallory bodies and neutrophil infiltration with necrosis of hepatocytes (typical alcoholic hepatitis) in two cases (died), alcoholic hepatitis with marked foamy degeneration in one case (died), hepatic fibrosis with conspicuous ballooning of hepatocytes and intrahepatic cholestasis in two cases (survived), and hepatic fibrosis without any necroinflammatory changes in one case (survived). In the latter three cases who survived, Mallory bodies were not observed by H & E and AZAN stains, electron microscopy, and indirect immunofluorescence method using anti-Mallory body antiserum. Neutrophil infiltration was also invisible in these three biopsy specimens.
These findings showed that even in severe acute alcoholic liver disease, histology of the liver varied from typical alcoholic hepatitis to hepatic fibrosis.

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The alterations of sinusoidal endothelial fenestration (SEF) were elucidated in rats liver acutely or chronically fed ethanol and after withdrawal of ethanol administration using scanning electron microscope. The liver sinusoids were perfused at 10 cmH2O pressure via portal vein and diameter, number and porosity of SEF were analysed morphometrically. There was heterogeneity in size and number of SEF in the hepatic lobule in control rats. In control rats, the diameter of SEF in zone 1 was significantly (p<0.001) larger than that in zone 3 and the number was significantly (p<0.001) more in zone 3 compared with zone 1. The porosity of zone 3 compared with zone 1 was significantly (p<0.05) larger. Chronic ethanol consumption led to significant enlargement (p<0.001) of diameter, decrease (p<0.001) in number and increase (p<0.01) in porosity in zone 3 compared with control. After withdrawal of ethanol administration these changes recovered to the control levels. The present results indicate that the alterations of SEF may play a role in the pathogenesis of alcoholic liver injury.

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Subtypes of antimitochondrial antibody (AMA) were investigated in patients with primary biliary cirrhosis (PBC) by an enzyme-linked immunosorbent assay (ELISA). Sixty-eight (89.5%) of 76 PBC patients were positive for anti-M2 by ELISA. Only three cases (3.9%) were positive for both anti-M2 and anti-M4 by ELISA. Two of these three patients died within one year after the manifestation of symptoms, revealing a rapid course of illness, although steroid therapy improved transientry their jaundice and clinical symptoms. Twelve (27.9%) of 43 patients who were positive for anti-M2 were also positive for anti-M8. The survival time was significantly shorter among the anti-M8 positive PBC patients by the generalized Wilcoxon test (p<0.01). Determination of subtypes of AMA in PBC is considered to be useful for diagnosis of CAH-PBC mixed type, and judging the prognosis of this disease.

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In order to clarify the actual effective site of secretin in the liver, the distribution of intravenously injected secretin was examined in dogs using a specific antisecretin antibody. The localization of secretin was examined with immunofluolescent and immunoperioxidase method and observed with light and electron microscopy serially after secretin injection.
By the immunofluorescent method, the fluorescence was already observed on the basolateral surface of ductal cells with various sizes compatible with bile ductules to septal ducts as early as 3 minutes after secretin injection, showing that the secretin receptor exists in all size of bile ducts.
By the immunoperioxidase method, the light microscopic observation revealed a diffuse staining in the cytoplasma of the ductal cells 20 minutes after secretin injection. Electron microscopic observation revealed a dominant staining of the basolateral plasma membrane, endoplasmic reticulum and intercellular vesicles, which suggested the positive uptake of secretin into the ductal cells.

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When heat-killed Propionibacterium acnes and lipopolysaccharide were injected intravenously into mice, liver cell necrosis with small granulomas in lobules and infiltrating cells in sinusoid were induced.
The number and character of infiltrating cells were histochemically investigated. The number of small granulomas and sinusoidal infiltrating cells increased gradually after intravenous injection of lipopolysaccharide. Infiltrating cells in small granulomas and in sinusoid mainly consisted of α1-antitrypsin positive cells and Naphthol AS-D Chloroacetate Esterase positive cells.
The proportion of α1-antitrypsin positive cells in total infiltrating cells decreased gradually, whereas the proportion of Naphthol AS-D Chloroacetate Esterase positive cells increased. These results suggest that infiltrating cells in the liver are mainly macrophages and neutrophils, and these two kinds of cells may play an important role in the development of acute hepatic injury in mice.

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Percutaneous transhepatic portography was performed in 65 cirrhotic patients with esophageal varices for the investigation of feeding veins of esophageal varices. In 12 of them (18%), the esophageal varices on the lesser curvature line were fed by left gastric vein and those on the greater curvature line were fed by short gastric vein. Then left gastric angiography and portography were performed in 20 patients before and after EIS for the study of upper epigastric collaterals by EIS. In 8 of them, the paraesophageal vein was found to be functioning as the drainage vein of the upper gastric blood network after EIS. In the other 12, the directional flow pattern of left gastric vein changed to hepatopetal and the left gastric vein was found to be the drainage vein of the upper stomach after EIS. These results suggest that left gastric angiography is useful for the evaluation of efficacy of EIS and post-EIS hemodynamic changes of the upper stomach. It is also concluded that the parasophageal vein and the feeding veins of esophageal varices should be left open for the drainage vein in EIS.

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Intrahepatic abnormal vessels were examined in autopsied livers with idiopathic portal hypertension (IPH) and extrahepatic portal obstruction (EHO). These abnormal vessels were divided into three types: portal, periportal and intralobular. Frequency of portal abnormal vessels was higher in EHO than in IPH; in EHO the larger the portal tract, the higher the frequency. By contrast, frequency of periportal and intralobular abnormal vessels was higher in IPH than in EHO. Serial section observations revealed that some of portal abnormal vessels were directly connected with the hepatic sinusoid, and this pattern was more frequent in EHO than in IPH. Serial sections also disclosed communications among portal, periportal and intralobular abnormal vessels, and this pattern was more frequent in IPH than in EHO. Thus, in IPH and EHO, sites of abnormal vessels varied with sites of portal venous obstruction, suggesting that these abnormal vessels are collateral pathways to obstructed portal venous radicles.

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To evaluate the influence of portosystemic shunting on pulmonary edema that occur in men with portal hypertention, extra vascular lung water were measured in rats underwent portocaval anastomosis or rats of portal hypertension which caused by occulusion of portocaval anastomosis. Extra vascular lung water (ml/kg) was found to be increased in both models when compared with sham operated controls, but the increase in lung water was statistical in only rats with portal hypertention. The rats with portocaval anastomosis had a 100% shunt, while the rats with portal hypertention had a lesser degree of shunting, because hepatopetal collateral vessels developed due to portal hypertention. So it is suggested that not only portosystemic shunting but also portal hypertention per se is responsible for pulmonary edema in portal hypertention.

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We investegated six chronic hepatitis B cases who seroconverted from HBe antigen to anti HBe by short term corticosteroid withdrawal therapy, who worsened after seroconversion. In five of them DNA-Polymerase was positive after seroconversion; this showed that the exacervation was caused by hepatitis B virus. We assessed histological prognosis by repeated liver biopsy in five cases: three showed histological aggravation and two showed no change. Intravenous glycyrrhizin was adminiStered to four of them. This proved effective for all of them, but in two cases the serum transaminase levels increased again after the dosage was reduced. Further treatment should be considered in such cases.

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We report a case of primary biliary cirrhosis (PBC) producing porto-systemic encephalopathy as first manifestation.
A 64-year-old female was admitted to our hospital becase of flapping tremor and disorientation. Main laboratory findings included ammonium level of 142μg/dl, an alkaline phosphatase level of 1, 273IU/l, an IgM serum concentration of 820mg/dl, and antimitochondrial antibody titer of 1:160. Endoscopy disclosed no esophageal varices. Portography showed giant inferior mesenteric vein (IMV) shunt, by which reversed blood flow from portal vein into IMV was developed, and diameter in IMV was 15mm compared with 9mm in portal vein.
Histological examination obtained wedge biopsy of the liver showed no regenerative nodules, and circular pads of collagen and inflammatory cells around the interlobular duct with epitheloid cells, producing characteristic Onion skin pattern.
Though PBC producing porto-systemic encephalopathy is an uncommon complication, it seems likely that it is very important in concidering cause and clinical manifestation of portal hypertension associated PBC.

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We report 2 cases with biliary tract stenosis caused by tuberculous adenitis. One patient was 28 year old man who presented symptom and biochemical evidence of biliary tract obstruction. By CT scan and ultrasonography, a mass in the region of head of pancreas was detected. He underwent laparotomy and recognized tuberculous adenitis of periportal lymph node which caused biliary tract stenosis. The other patient was 20 year old woman who complained abdominal discomfort. An abdominal sonogram revealed a mass at head of pancreas. She underwent laparotomy Which revealed tuberculous adenitis of periportal lymph node. The CT scan showed soft tissue mass at head of pancreas. Ring enhancement and nodular enhancement of the mass were observed in both of the cases. This sign of CT scan was thought to be characteristic of tuberculous adenitiS and useful for preoperative diagnosis.

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