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Multiple endocrine neoplasia type 1 (MEN1) is characterized by the combined occurrence of primary hyperparathyroidism, pancreatic endocrine tumors, and neoplasms of the anterior pituitary gland. The disease is inherited as an autosomal dominant disorder with a high penetrance. Although many investigators have localized the causative genes to chromosome 11q3 by linkage analysis, the MEN1 gene remains unidentified. The use of molecular genetic markers in family linkage studies, however, have made it possible to identify gene carriers. Repetitive screening combined with the assignment of gene-carrier status will provide possibilities for therapeutic or prophylactic intervention earlier in the development of each of the manifestations of this syndrome, such as gastrointestinal bleeding secondary to ulcers or malignant transformation.

The main etiological cause of liver cirrhosis that account for approximately 80% of liver cirrhosis in Japan in hepatitis virus, and HBV and HCV account for 38% and 59% of this hepatitis virus-induced liver cirrhosis, respectively. Liver cirrhosis develops in patients with persistent infection of HBV or HCV. A diminution in HBV replication can occur due to the immune response in cases with chronic hepatitis. In such cases, the liver disease may become almost normal or inactive after conversion to the nonreplicative phase. To the contrary, in some cases with HBV infection, such conversion does not occur leading finally to liver cirrhosis. Chronic infection takes place in 65% of the patients exposed to HCV, which results in the development of chronic hepatitis, and only quite rarely resolves. About 40% of these patients with chronic HCV infection will develop liver cirrhosis in 10 to 20 years.