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From April 1989 to December 2004, we performed liver biopsy on 475 patients and obtained biopsy proven 35 cases of non-alcoholic fatty liver. Among them, 18 cases were diagnosed as non-alcoholic steatohepatitis (NASH). During the last three years, we have tried to detect NASH using ultrasonography and elevated value of serum ferritin (> 300 ng/ml). All of the eligible 7 cases biopsied during the course were diagnosed as NASH. In these 7 cases, ALT levels improved after the body weight loss accompanied by the parallel decrease of serum ferritin levels. Measurement of serum ferritin is useful in the detection of NASH but the normal value of ferritin cannot rule out the possibility of NASH.

Since the late 1980s, there has been an increasing tendency in the number of case reports on Stevens-Johnson syndrome accompanied by acute hepatitis in workers exposed to trichloroethylene from Asian countries. Recently, mass outbreaks of it have been disclosed in the Philippines and China. Besides trichloroethylene, although the number is small, a similar health disorder has also occurred in workers using tetrachloroethylene. Since the above-mentioned facts are not yet well recognized in the occupational health community, this review is aimed at making clear (1) the clinical features of the health disorder, (2) details of patients' jobs, working environments, and exposure to hazardous chemicals, and (3) the relationship between exposure to trichloroethylene or tetrachloroethylene and the health disorder. Based on a critical review of articles, the following were pointed out. First, it is important to carefully observe the health status of workers exposed to trichloroethylene or tetrachloroethylene and to take countermeasures to reduce exposure. Secondly, circumstantial evidence suggests a cause-effect relationship between the two chemicals and the health disorder; but at the present time it is impossible to rule out the participation of unelucidated factors promoting the occurrence of the health disorder or the existence of a hidden genuine causative substance. Therefore further investigation to trace such a case is needed. Thirdly, the mechanism of the health disorder and the reason why there seems to be a large inter-individual difference in sensitivity to the causative agent should be clarified.

Two thousand five hundred ninety-six consecutive patients who received blood transfusion for the first time within one week and had no liver dysfunction before transfusion had been selected from 8637 patients who received blood transfusion at the hospital between 1982 and 1987. The influence of dose, components of transfused blood and sex, age of recipients on the incidence of post-transfusion hepatitis was investigated. The rate of development of hepatitis depended on the dose of transfusion, not on sex and age of recipients. The rate of development of hepatitis raised as number of transfused blood increased without limiting point to 100%. The carrier rate of healthy population of non-A, non-B hepatitis virus was estimated 1.39%. Stored blood, concentrated red blood cell and fresh blood are high risk components and fresh frozen plasma was low risk component.