A case of typical megaloblastic anemia was reported, patient is a 48 rears old femalewith chief complaint of nahsea and vomitting.
Main clinical findings were as follows; gastric hypoacidity by histamine stimulation, low uropepsin excretion, atrophic granular gastritis by gastrocamera which showed nobenefical changes by treatment, severe atrophic gastritis by gastric biopsy, and the socalled- “large active cells” were found by gatric cytology.
The anemia was improved by the the administration of Vit. B₁₂ (Fresmin).

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Up to recent times, portal hypertension has usually been classified into intra- andextra-hepatic groups. But investigations based on this classification have not been usefulto explain the mechanism of various clinical manifestations of portal hypertension.
In 1960 Imanaga presented the following classification of portal hypertension, stressingthat the state of intrahepatic circulatory disturbances should be taken into consideration;
Group I Extrahepatic obstruction of the portal vein
Group II Intrahepatic obstruction of the portal vein
Group III Intrahepatic obstruction of the hepatic vein
Subgroup 1 Obstruction of the hepatic vein only
Subgroup 2 Obstruction of both hepatic and portal veins
Group IV Extrahepatic obstruction of the hepatic vein
This paper is concerned with histological studies of the liver in 129 operated cases ofportal hypertension based on Imanaga's classification. The results were as follows:
1. In Group I, the histological findings of the livers showed periportal fibrosis ofvarious degrees which was characterized by sharply demarcated fibrous proliferation.
2. The typical histological feature of the livers of Group II can be defined as periportalfibrosis. Namely, no pathological changes were detected in the central venousregion, but the portal venules showed various alterations such as narrowing of theintravascular space and the infiltration of round cells around the portal venules, which were assumed to cause the state of presinusoidal portal hypertension.
3. The livers of Group III manifested varying degrees of liver cirrhosis without anexception. In a great majority of patients of Subgroup 1 was found cirrhosis of TypeA (NAGAYO) and in patients of Subgroup 2, cirrhosis of Type B (NAGAYO) was therepresentative feature. In all histological specimens of the lives of this group, especiallyof Subgroup 1, the central veins were hardly recognized. This fact is assumed to suggestthat the portal hypertension in this group is postsinusoidal in nature. Another factthat the average portal pressure in patients of Subgroup 2 was significantly higherthan in those of Subgroup 1 is considered to be due to the large regenerative nodulesfound in the livers of cirrhosis of Type B (NAGAYO) which cause compression on bothinter-and intra-nodular portal venules.
4. The livers of Group IV were exclusively characterized by congestive hepatic cirrhosis.
From the aforementioned results, it was concluded that the representative features ofeach group seem to support morphologically the state of the intrahepatic circulatorydisturbaces in patients with portal hypertension, when morphologic alterations of thelivers in patients with portal hypertension were studied in view of Imanaga's classification.

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