HCV related antibodies (C100-3, GOR, 2nd) were investigated in 209 transfusional cases. 7 (3.3%) were defined as posttransfusional hepatitis (PTH), 15 (7.2%) were suspected PTH. 4 cases of defined PTH and 3 cases of suspected PTH changed to positive for some HCV related antibodies. All positive cases for anti-HCV had ALT peaks after 4 weeks. In some cases, 2 ALT peaks were found. We attributed the first ALT peaks to the operations. Some cases with the second peak after 4 weeks turned to positive for anti-HCV. In positive cases, defined cases had higher ALT peaks and optical density of anti-HCV (C100-3) and shorter durations until ALT peaks than suspected cases. We attributed this to the volume of virus. The present standards of PTH diagnosis have several shortcomings. We believe that the new standards of PTH diagnosis, including the findings of HCV antibodies are more useful.

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E2/NS1 region, putative surface antigen of hepatitis C virus (HCV), contains two hypervariable regions (HVRs). To get insight of the clinical significance of HVRs, detecting system for E2/NS1 protein was established using 5 kinds of polyclonal antibodies against recombinant proteins of the regions expressed in E. coli.
As low as 10 ng of the recombinant proteins were specifically detected in this system. Crossreaction studies of the 5 antibodies against the proteins suggested that heterogeneity of amino acid sequences in HVRs is closely correlative with affinity of the antibodies. A protein corresponding to size of 44 kDa was specifically observed in a liver sample from a patient with chronic active hepatitis C using this system. Also, reactivity of the 44 kDa protein against the antibodies was different among these 5 antibodies.
Thus, these results indicate that HVRs may have an important role on immune system against HCV.

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A human intrahepatic cholangiocellular carcinoma cell line, designated CCKS1, was established from the peritoneal metastasis of a 60-year-old man. We purified the cancer cells using the microexplant culture method on collagen gel, and cultured over 100 passages in the flasks. The CCKS1 cells had 60 hours of the doubling time and 63 of the modal chromosomal numbers and showed monoclonal proliferation. They were polyhydral in shape with the epithelial connections and grew as monolayers producing mucin, CEA and CA19/9. Ultrastructural studies revealed the presence of poorly developed microvilli on the luminal cell surface and tight junctions of upper lateral side. The tumor formed by heterotransplantation to nude mice showed the same histology as original pritoneal metastasis, that is, moderately differentiated adenocarcinoma with cribriform pattern. The CCKS1 may be usefull for the studies of intrahepatic cholangiocellular carcinoma.

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Nuclear DNA contents of hepatocytes and tumor cells were measured by means of microspectrophotometry. Eighty-six tumorous regionS and 44 non-tumorous regions from 27 hepatocellular carcinoma (HCC) cases and 13 control regions were submitted to study. All non-tumorous regions and well differentiated HCCs showed a diploid pattern whereas poorly differentiated HCCs expressed an aneuploid pattern, and moderately differentiated HCCs did not exhibit any constant ploidy pattern. Seven parameters related to nuclear DNA contents were selected, and their diagnostic coefficiencies were investigated. The value for 6 n≤%, a parameter indicating the frequency of polyploid cells, was most effective for determining the histologic grade of malignancy, with a diagnostic accuracy of 87%. The relationship between nuclear DNA content and proliferating cell nuclear antigen labeling index and/or cytologic morphometry did not further contribute to the objective and accurate evaluation of histologic grade of differentiation. From the results obtained, the author concludes that microspectrophotometrical studies of nuclear DNA are not assist in the objective determination of the histologic grade of HCC.

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The cellular oncogene c-myc is transiently expressed in the remnant liver after 70% partial hepatectomy. In order to investigate the significance of this expression during liver regeneration, the localization of c-myc expression and DNA synthesis in the remnant liver after partial hepatectomy were examined by in situ hybridization with digoxigenin-labelled RNA probes and by uptake of Bromodeoxyuridine. Slight c-myc mRNA expression was found only in the cytoplasm of hepatic parenchymal cells in the peripheral region of the hepatic lobules (Zone 1) 30 minutes after hepatectomy. This expresSion was markedly increased in Zone 1, two hours later. Four hourS later, the expression was also found in the central region of the hepatic lobules (Zone 3). Twenty-four hours after hepatectomy, DNA synthesis in the remnant liver after partial hepatectomy began in Zone 1 and expanded to Zone 3 after that, C-myc mRNA expresSion and DNA synthesis in this model showed a similar pattern. These resultS suggest that c-myc mRNA plays an important role in signal transmission during liver regeneration.

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Metabolism of albumin in rat liver with partial hepatectomy (PH) by following view points was investigated. Albumin-immunoreactivity in the liver tissues was observed by immunocytochemistry, and fine structure of roulgh endoplasmic reticulm was studied by electronmicroscopy. In addition uptake of ³H-leucine into albumin synthesis was measured by liquid scintillator. Albumin in serum was higher at day 10 after PH than that at day 2 or 5, however albumin-immunoreactivity in hepatocytes was more intense at day 5 than that day 2 or 10, and lamella of rough endoplasmic reticulum was more developed at day 5. Scintillation counter showed higher uptake of 3H-leucine into albumin synthesis at day 5 than that at day 2 or 10. These data suggested that albumin synthesis in the liver tissue was alterated during regeneration after PH and that its synthesis was more active at day 5 than that at day 2 or 10 and serum albumin was elevated at day 10.

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A 70-year-old woman was admitted to our hospital with general fatigue, anorexia and jaundice. Laboratory data on admission revealed acute hepatitis like abnormality such as GOT 1453IU/l, GPT 1031IU/l and total bilirubin 8.4mg/dl. There was no evidence of viral hepatitis type A, B or C. She was diagnosed as acute phase of autoimmune hepatitis because of increased serum IgG level (4246mg/dl), and positive serum anti-nuclelar-antibody. The liver biopsy specimen showed chronic active hepatitis.
Since the serum level of free-T₃ on admission was very low (1.36pg/dl) while those of free-T₄ and TSH were normal, she was diagnosed to be complicated with low T₃ syndrome. The oral administration of prednisolone started from 40mg/day improved her symptoms and abnormality of liver function tests. However, the serum F-T₃ level was once decreased to undertactable level and then gradually increased with the tapering of prednisolone dosage.
It is suggested that low T₃ syndrome is associated with acute onset autoimmune hepatitis and it is accelerated by the corticosteroid hormone therapy.

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We report two cases of Dubin-Johnson syndrome associated with chronic hepatitis, type C and hepatocellular carcinoma. They were revealed to have hyperbilirubinemia and retardation of ICG and BSP excretion. So extent of hepatectomy were decided by biochemical data on liver function. Left and right lobectomies were successfully carried out for case 1 and 2, respectively.
On electron microscopic examination, electron dense granules were found in non-HCC hepatocytes of the two cases, and in carcinoma cells in case 1.

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A 64-year-old man was admitted with fever and right hypochondriac pain. A liver tumor was detected in the anterior segment by imaging diagnosis. Partial resection was performed with 1 cm surgical margin. The tumor was diagnosed as a malignant lymphoma classified in diffuse large cell type by the histological examination. He has no recurrence, 5 years after operation and additional multi-agent chemotherapy (VEMP).
Primary hepatic malignant lymphoma is rare disease with 18 resected cases reported including this cases. Fourteen males and 4 males with a mean age of 42.2 years, with the surgical management of partial resection in 3, segmentectomy in one, lobectomy in 6 and trisegmentectomy in 8 cases, have been reported, 17 cases were classified in diffuse type by the Lymphoma Study Group. Adjuvant chemotherapy was performed after operation in 14 cases. Two patients died of operative complication and tumor recurrence, respectivley.
It is suggested that primary hepatic malignant lymphoma without extrahepatic tumor can be successful managed by operation and adjuvant chemotherapy.

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We reported a case of NRHL associated with PN, diagnosed by needle biopsy of the liver during long-termed medication. In July 1982, a 67-year-old man was diagnosed as PN by necrotizing angitis in many organs and microaneurysm of hepatic artery. Before starting medication with predonisolone and cyclophosphamide, the liver specimen revealed no abnormality. No relapse had occurred after treatment. However, ascites and splenomegaly were found in April 1990. Needle biopsy of the liver was performed for diagnosis. Intralobular nodular formation and atrophy without fibrosis in the interventing tissue by compression were found. Neither necrotizing angitis nor portal venous thrombosis was seen. These findings suggest that predonisolone and/or cyclophosphamide may cause nodular formation of hepatocytes.

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