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It is well known that long-term infection with Clonorchis sinensis often causes bile duct cancer, usually. It occurs in the intrahepatic bile duct. We encountered a rare case of clonorchiasis complicated with duodenal papillary cancer. The patient was a woman from China. Although clonorchiasis is rarely found in Japan, the promotion of international exchange may increase the number of visitors from endemic areas. Thus we must pay sufficient attention to this disease. Also, we reported that the microplate ELISA technique was useful in the diagnosis of clonorchiasis with high accuracy in this case.

To clarify the characteristics of cell surface Pre-S2 Ag, HBcAg and HBeAg immunohistochemically and to explore their relationship with a cellular immune target antigen, 31 liver biopsy specimens from chronic HBV carriers were examined by immunoperoxidase staining. By immune light microscopy, Pre-S2 Ag was detected on the liver cell membrane in 18 (58%) of the 31 cases, HBcAg in 4 cases (13%) and HBeAg in 4 cases (13%). Pre-S2 Ag frequently showed a honeycomb-like membrane expression pattern which was present regardless of liver inflammation, whereas HBcAg and HBeAg exhibited a scattered membrane expression pattern detected in areas of marked inflammation. Of the 18 cases showing a honeycomb-like Pre-S2 Ag expression, 3 concomitantly showed a scattered membrane expression pattern. Immunoelectron microscopy revealed these two distinct membrane expression patterns. In areas showing a honeycomb-like membrane expression pattern, Pre-S2 Ag was demonstrated in the intercellular space and on the basolateral membranes of hepatocytes, but was not detected on the cell membranes in areas of the intercellular space lacking an immunoreaction. Cytoplasmic expression of Pre-S2 Ag was less extensive in these hepatocytes. These findings suggest that the honeycomb-like membrane expression of Pre-S2 Ag results from attachment of extracellular antigen to the liver cell membrane. In contrast, in areas showing a scattered membrane expression pattern, Pre-S2 Ag, HBcAg and HBeAg were each detected as single-layered linear deposits along the cell membrane, but were absent in the intercellular space. Each antigen was also expressed abundantly in the cytoplasm, and the immunoproducts appeared to fuse with the cell membrane. These findings suggest that the scattered membrane expression of these antigens results from intrahepatic transfer of antigen synthesized in the liver cell to the cell membrane, possibly serving as a target for the host immune-mediated response in connection with inflammation.

We have investigated the effect of CoQ10 to lipid peroxide (LPO) and Cu, Zn-SOD in the regenerating liver in rats. Cu, Zn-SOD was investigated in biochemical activity, and immunohistochemical localization. In normal control liver, Cu, Zn-SOD was diffusely stained throughout the hepatic lobules, with predominance in the centrilobular area and with vicinity of thick portal vein. In early stage of regenerating liver. LPO was increased and Cu, Zu-SOD was decreased. Destruction of the membrane of hepatocyte was confirmed by electron microscopy in the early stage of regenerating liver, Cu, Zn-SOD might be speculated to leak out into extra cellular spaces. CoQ10 suppressed the mentioned phenomenon in regenerating liver.

Thirty three resected gastric lesions were examined histologically to analyze the relationship between histologic and cytologic diagnoses of the so-called atypical epithelial growth based on biopsy specimens. Of the 33 lesions twenty were histologically verified atypical epithelial growth and the remaining thirteen were, in the same manner, diagnosed with some equivocation as papillary adenocarcinoma. The results of both histological and cytological diagnoses of the biopsy materials from the above mentioned 33 lesions were as follows; for the twenty atypical epithelial growths, 18 were diagnosed as benign, one was as suspicious of malignancy and the other one was as cancer by biopsy histology, whereas these lesions were diagnosed as benign in 16, suspicious in two and cancer in two by cytology; for the thirteen papillary adenocarcinoma, 8 were diagnosed as benign, 4 were as suspicious of malignancy and one was as cancer by biopsy histology. On the other hand their diagnoses were malignant in six, suspicious of cancer in four and benign in three by biopsy cytology. The data indicate that biopsy cytology favors malignancy for atypical epithelial growth and papillary adenocarcinoma when compared with biopsy histology.

Cholecystokinin (CCK)-like activities in the duodenal mucosa were measured by bioassay in patients with duodenal ulcer, cholelithiasis and some other gastrointestinal diseases as well as in healthy normal subjects. The mean CCK-like activity of the duodenal mucosa in patients with duodenal ulcer and cholelithiasis was 0.405 Ivy dog units per milligram and 0.376 Ivy dog units per milligram of dry weight of the duodenal mucosa (IDU/mg d.w.), respectively. Both these figures are significantly higher than 0.180 IDU/mg d.w. in normal subjects (p less than 0.005, p less than 0.005, respectively). It can be speculated that the CCK-level of the duodenal mucosa in patients with cholelithiasis may be regulated by a feedback mechanism and CCK in patients with duodenal ulcer may act physiologically for the cure of duodenal ulcer.

Computerized morphometrical measurements were made of liver cells and their nuclei taken from livers of healthy persons and from patients with acute hepatitis (AH), chronic hepatitis (CH), and liver cirrhosis (LC). Liver biopsies were performed on 127 people (24 convalescing from acute hepatitis, 20 with chronic inactive hepatitis (CIH), 24 with chronic active hepatitis (CAH), 38 with liver cirrhosis (LC) and 21 who were healthy controls (HC]. The specimens were stained with hematoxylin-eosin, then light microscopic pictures were obtained. The original cells were magnified 1000 times. The sizes of the cells and of their nuclei were calculated using a computer. Correlative variation was noted in cell and nuclear sizes resulting in an consistently constant nucleus-cytoplasm ratio. Average sizes of both cells and nuclei were maximal in livers with LC, followed in decreasing order by those in livers with CAH, CIH, HC and convalescent AH. The smallest cells and nuclei were found in convalescent AH cases. It might be possible to some degree to obtain gross impressions of the histopathological type of the liver lesion by measuring the sizes of cells and nuclei of the liver.

In rats with experimental liver injuries and humans with various liver diseases, fluorescence from the liver surface after intravenous injection of 10% fluorescein-sodium was investigated. Our improved fluorescence laparoscopy allowed clear fluorescent images. In normal rats and in cases of nonspecific reactive hepatitis, fluorescence was first found in the portal area of the liver surface; it was then observed spreading into the lobules towards the central veins. In damaged livers of both rats and human, bright fluorescence was observed in arterioles, necrotic foci, and fibrotic areas on the liver surface. The patterns of fluorescence which appeared in the early phase after intravenous injection of fluorescein-sodium seemed to reflect the shapes and distribution patterns of the portal areas. These results suggest that observations with improved fluorescence laparoscopy are useful for diagnoses of liver diseases.