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We conducted an epidemiological study of 509 residents of H town, Fukuoka, Japan, to investigate the high mortality rate from liver disease. Antibodies to hepatitis C virus (HCV) (anti-HCV) were detected in 120 residents (23.6%); HCV RNA in 91 (17.9%), and hepatitis B surface antigen (HBsAg) in 13 (2.6%). Multivariate logistic regression analyses showed that presence of anti-HCV, male gender, and history of liver disease were associated with the presence of liver dysfunction, and that age of more than 40 years and a particular district were associated with the presence of anti-HCV. HCV RNA was more frequently detected in anti-HCV-positive men than women (41, or 85.4% versus 50, or 69.4%) (P < 0.05). The incidence of liver dysfunction was significantly higher in HCV RNA-positive men than women (32, or 66.7% versus 22, or 30.6%) (P < 0.05). These findings suggest that: (1) HCV was correlated with the high mortality rate from liver diseases, (2) there were district-related differences in the incidence of HCV, and (3) the lower frequency of elimination of HCV from men may explain why they showed a high mortality from liver disease.

An epidemiologic study was performed to investigate GBV-C/HGV infection in 460 inhabitants of H town where hepatitis C virus (HCV) is hyper endemic. GBV-C/HGV RNA was detected by reverse transcription hemi-nested polymerase chain reaction (RT-heminested PCR) for the 5′ untranslated region (5′-UTR). The nucleotide sequences of GBV-C/HGV 5′-UTR were determined and phylogenetic analysis was performed. GBV-C/HGV RNA, antibody to HCV (anti-HCV), and HCV RNA were detected in 12 (2.6%), 108 (23.5%), and 87 of subjects (18.9%), respectively. The phylogenetic tree analysis indicated that the 12 GBV-C/HGV-positive isolates could be classified as a new GBV-C/HGV group (type 3). No intraspousal transmission of GBV-C/HGV was observed. Four subjects positive for GBV-C/HGV RNA without HCV RNA had normal mean aminotransferase concentration. This study indicated: 1, the prevalence of GBV-C/HGV was lower than that of HCV: 2, Type 3 GBV-C/HGV was the most prevalent; 3. No intraspousal transmission of GBV-C/HGV was observed; and 4, GBV-C/HGV alone may not cause severe liver injury.

Aim, clinical usefulness of a non radioactive HBV DNA measuring method was evaluated. Subjects and methods, the subjects were 8 anti-HBe positive chronic hepatitis B (CH-B) patients and five CH-B patients who were orally administered reverse transcriptase inhibitor (RTI). Serum HBV DNA and DNA-P were serially determined at 1.5–2 month intervals for 1 year in CH-B with anti-HBe positive patients and before, 2, 4, 8, and 12 weeks after RTI administration. Serum HBV DNA was determined by two different non radioactive method (Viraprobe HB Lumi, Quantiplex HBV DNA). Results, the HBV DNA levels measured with two methods were highly correlated (P

Four patients with inflammatory myopathy positive for anti-hepatitis C virus are described. One male and three females are included in this report. Mean age of the four patients was 50 years (range 42–60 years). They were referred to our hospital with muscle weakness or myalgia. Active hepatitis C virus infection was confirmed by the detection of hepatitis C virus RNA with the polymerase chain reaction method in sera of these patients. Serum muscle enzymes, such as creatine kinase, lactate dehydrogenase, aspartate aminotransferase, and aldolase were elevated. Inflammation in the muscle tissue was demonstrated in the muscle biopsy specimens from these patients. The patients received prednisolone and symptoms and elevated muscle enzymes were improved. It is suggested that hepatitis C virus might be one of the possible etiologic factors responsible for inflammatory myopathy.

SUMMARY. The mortality rate from liver disease in H town of the Fukuoka prefecture in Japan is significantly higher in men than in women. To clarify the gender-related difference, we evaluated subjects with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the S area of this town. A total of 824 adults participated in this study, 332 men and 492 women. The incidence of positivity for hepatitis B surface antigen (HBsAg) in serum did not differ significantly between the subjects in the S area (1.9%) and Japanese blood donors (1.5%); however, the incidence of positivity for serum antibody to hepatitis C virus (HCVAb) in the subjects (31.8%) greatly exceeded that in Japanese blood donors (1.3%). The rate of positivity for HCVAb did not differ significantly between men (28.3%) and women (34.1%), but the proportion of serum HCV RNA-positive to HCVAb-positive subjects was significantly higher in men (78.2% in men vs 67.3% in women). The incidence of elevated serum alanine aminotransferase (ALT) in subjects positive for serum HCV RNA was also significantly higher in men (77.0% in men vs 55.8% in women). These results suggest that a more frequent elimination of HCV from serum in women may explain the observed lower mortality from liver disease.

In a series of 52 malignant thymic tumors at our institution between 19751986, there were 34 thymomas, 4 thymic carcinomas, 5 germ cell tumors, 1 thymic carcinoid, 1 thymic malignant fibrous histiocytoma, and 7 malignant lymphomas.Aggressive surgical resection of tumors combined with chemotherapy and/or irradiation were tried to perform for these tumors. Thymomas, thymic carcinomas, and a thymic carcinoid seem to be good after the treatment.On the other hand, germ cell tumors and malignant lymphomas seem to be not good. Treatment effects for complications of thymomas were not satisfactory except for myasthenia gravis. Localized recurrences could be managed by surgical resection and/or irradiation, and W-CT is a useful examination to detect recurrences of tumors at early stage.

We studied serum acute phase reactant (APR) levels in 45 pediatric surgical patients. Alpha 1-acid glycoprotein (alpha 1-AG) showed a peak value on day 3 postoperatively (P.O.) and alpha 1-antitrypsin (alpha 1-AT) showed a high value on days 3-5 P.O. These glycoproteins returned to normal levels by day 21 P.O., but the level of haptoglobin (Hp) remained high until day 21 P.O. The postoperative changes of alpha 1-AG and alpha 1-AT correlated with the process of recovery from inflammatory conditions, but C-reactive protein (CRP) reached a peak on days 1-2 P.O. and returned to normal limits by day 14 P.O. In patients with infection, CRP returned to the normal level rapidly before recovery from infection. Of the 3 glycoproteins, alpha 1-AG seemed to be a valuable indicator of the pathological conditions. Postoperative changes in APR levels should be useful for early detection of postoperative complications. Persistent ileus led to an increase in APR levels, as a consequence of an inflammatory reaction due to breakdown of the intestinal mucosal barrier.