Yutaka Inagaki

Evaluation of Esophago‐gastric Varices with Endoscopic Ultrasonography

Esophago‐gastric varices of 22 patients were studied using a newly developed method of endoscopic ultrasonography (EUS). During the observation, the esophagus was filled with de‐aerated water, and reflux of the water was prevented using a balloon placed 7 cm proximal to the tip of the endoscope. Thirteen of 22 patients received endoscopic sclerotherapy (EIS) for their esophago‐gastric varices, and sequential changes of the varices were observed mith EUS.

Susceptibility to primary biliary cirrhosis is associated with human leukocyte antigen DRB1*0803 in Japanese patients

An association of primary biliary cirrhosis (PBC) with human leukocyte antigen (HLA) class II has been reported in previous studies based on the results of serological HLA typing. To evaluate the association between PBC and HLA class II more precisely, we performed HLA-DRB1 and DPB1 genotyping in 53 Japanese patients with PBC using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. In DRB1 genotyping, the frequency of the*0803 allele was significantly higher in patients with PBC than that in control subjects. Twenty out of 53 patients were*0803 positive (37.7%), whereas only five out of 60 controls (8.3%) had the allele (relative risk = 6.67;P < 0.001; correctedP < 0.05). In DPB1 genotyping, there was no significant difference in the frequency of the DPB1 alleles between patients with PBC and controls. Amino acid analysis of the DRβ chain revealed that the frequency of leucine at position 74 was significantly higher in patients with PBC than that in controls. These results suggest that HLA-DRB1*0803 allele and a subsequent amino acid substitution encoded by the polymorphic regions of the allele may play an important role in the pathogenesis of PBC.

Clinical features and diagnosis of primary liver cancer

Primary liver cancer is one of the most common causes of cancer death in Japan, and approximately 23,000 patients died of this cancer in 1989 [1]. Moreover, the number of deaths due to primary liver cancer is increasing markedly every year. Hepatocellular carcinoma (HCC) accounts for 90% of primary liver cancer in Japan, and 80 to 90% of HCC is associated with liver cirrhosis [2, 3]. Poor hepatic functional reserve due to underlying cirrhosis is the major factor which limits extended surgical resection in many cases. Obviously it is important to detect HCC at an early stage for curative treatment.

Reduced expression of cellularfos gene in peripheral blood mononuclear cells of patients with primary biliary cirrhosis

Abstract Abnormal expression of certain cellular oncogenes in peripheral blood mononuclear cells (PBMC) is associated with several autoimmune disorders and is thought to reflect a pathologically activated state in various lymphocytic subpopulations. Using the Northern blot hybridization technique, we studied the expression of cellular (c-) fos , c- myc and N- ras genes in PBMC isolated from patients with primary biliary cirrhosis (PBC) and normal control subjects. The expression of c- fos gene was reduced significantly in patients with PBC, while there was no significant difference between the two groups in the expression of c- myc and N- ras genes. Stimulation of PBMC with mitogens in vitro increased c- fos gene expression markedly to a similar extent in both normal subjects and in patients with PBC. Furthermore, the reduced expression of c- fos gene recovered significantly in all the patients examined after treatment with ursodeoxycholic acid (UDCA). These results suggest that the reduced expression of c- fos gene in PBMC is a reversible functional manifestation of PBC and that UDCA therapy for PBC may improve abnormal lymphocyte function.