Hematological values were studied in cases of a thorough physical examination, chronic hepatitis and alcoholic liver injury. Cases of a thorough physical examination were a control group. Only thrombocyte count was decreased in cases of chronic hepatitis as compared with a control group. On the other hand a red blood cell count, MCV, MCH and neutrophils were changed significantly in cases of alcoholic liver injury. A red blood cell count was decreased, but MCV, MCH and neutrophils were increased. Correlation between MCV and each item of liver function tests was studied. No significantly correlated item was found in a control group and cases of chronic hepatitis, but GOT/GPT, LDH and CHE were significantly correlated in cases of alcoholic liver injury.

It was reported that steroid withdrawal therapy was beneficial in the management of patients with HBsAg-positive chronic active hepatitis and rarely led to fulminant hepatitis. We report a caseof chronic active hepatitis type B who developed severe liver dysfunction by steroid withdrawal therapy, and died one month later.
A 37-year-old man with HBsAg-and HBeAg-positive chronic hepatitis received steroid withdrawal therapy at the time of elevated transaminase (S-GOT 952u, S-GPT 877u).
The dosage of prednisolone was 40 mg/day at the first week, then decreased by 10 mg everyweek. Total doses were 700 mg in 4 weeks. A rebound S-GOT peak was observed at one week after the discontinuation of prednisolone. At this time, he complained of increasing general fatigue and loss of appetite. The laboratory data showed severe liver dysfunction (Prothrombin time 38%, Hepaplastin test 19%). Ascites was observed by the abdominal CT scanning. Then total bilirubin level increased gradually and urine volume decreased. Finally he died at one month after the discontinuation of prednisolone.

We gathered information of both drinking and smoking habits by questionnaires. Objects of our study were 246 male cases around Yanai City. These cases were divided into six groups. The 1st: less than 20 grams of ethyl alcohol daily and less than 10 cigarettes daily (56 cases). The 2nd: 20 grams and less than 10 cigarettes (39 cases). The 3rd: more than 40 grams daily and less than 10 cigarettes (36 cases). The 4th: less than 20 grams and more than 10 cigarettes (36 cases). The 5th: 20 grams and more than 10 cigarettes (23 cases). The 6th: more than 40 grams daily and more than 10 cigarettes (56 cases).
The 1st group was a control group, and was compared among the 4th, 5th and 6th group. Consequently obesity index and serum total protein level were decreased signifiacantly in the 5th and the 6th group. There were no significantly different items in the 4th group. It was thought that both drinking and smoking habits suppressed a nutritional state of a whole body.

The HCV antibody positive rates of blood donors were studied in Yamaguchi Prefecture. C100-3 antibody was examined by the method of the 1st generation. The subjects were 146, 792 people who donated blood from Nov. 1989 to Dec. 1990. The average positive rate was 1.01% in Yamaguchi Prefecture. The positive rates of more than 3% were registered in four towns. In one town out of these four, the average positive rate was 22.0% It was extremely higher than the other three towns. Further study will be required to elucidate such regional differences in the HCV positive rate in the prefecture.

Patients with chronic liver diseases who were hospitalized into our clinic were studied. Chronic liver diseases consisted of three groups, namely chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Patients with peptic ulcer were studied as a control group. The mean age was the difference of 8.4 years between a group of chronic hepatitis and that of liver cirrhosis, but only 3.0 years between a group of liver cirrhosis and that of hepatocellular carcinoma. HBs antigen positive ratio was almostly same between a group of chronic hepatitis and that of liver cirrhosis, but about twice in a group of hepatocellular carcinoma. Ratio of hard drinker was lowest in a group of hepatocellular carcinoma, and therefore we considered that the effects of alcohol upon carcinogenesis were little. HBs antibody positive ratio was no difference among groups of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma.

Liver function influenced by drinking were studied in cases of a thorough physical examination. Objects of our study were 172 cases who entered in our clinic during past two years. 172 cases were divided into three groups. 1st group was 70 cases who had drunk less than 20 grams of ethyl alcohol a day, 2nd group was 49 cases who had drunk 20 grams a day and 3rd group was 53 cases who had drunk 40 grams a day.
GOT, GOT/GPT, γ-GTP, CHE and LAP were changed significantly with the increase of drinking as a result of study of these three groups. Especially it was thought that GOT/GPT, γ-GTP and LAP reflected most sharply the grade of alcoholic liver injury.

We have done the questionnaire about patients with hepatocellular carcinoma in Yamaguchi prefecture. The result was that 304 cases were answered. The mean age was 62.1 years old, and the ratio of male to female was 3.7 to 1. Abdominal ultrasonography was examined most frequently, and the next was computed tomography as the method of diagnosis. The serum α-fetoprotein level showed less than 400ng/ml in cases of 49.3%. HBs antigen was positive in cases of 15.9%. Positive cases were significantly lower in the mean age as compared with negative cases, and the ratio of male to female was 8.2 to 1. Liver cirrhosis was complicated in cases of 84%.

A first case is a 43-year-old male. He was admitted after hard drinking, and died two days later for hepatic coma. It is thought that this case applies to a diagnostic criteria of severe alcoholic hepatitis made by a Japanese reserch group about the relation of alcohol to liver. A second case is a 45-year-old male. He was also admitted after hard drinking, but he recovered rapidly. This case was diagnosed as Zieve's syndrome, because hyperlipemia and hemolytic anemia were found.
Volumes of liver and spleen in these two cases were examined by computed tomography. Volumes of liver were more increased and those of spleen were more decreased than those of controls. In a second case a volume of liver was decreased gradually, and that of spleen was increased with recovery from sickness. It is thought that a volume of liver is increased in a patient with alcoholic hepatitis, because liver cells fall into ballooning. But the cause is unknown as yet that a volume of spleen is decreased.

The ratio of men to women was studied in 331 patients hospitalized into our department for the past three years for various liver diseases. Two factors seemed to affect the sex difference in the morbidity of liver disease. One was a history of drinking, the other a positive ratio of HBs antigen. So, heavy drinkers and HBs antigen positive cases were excluded from the patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma, and the male/female ratio was studied again. The ratio of men to women in the patients with liver cirrhosis was 1.3: 1, 4. 1: 1 in the patients with hepatocellular carcinoma and 2.0: 1 in the patients with chronic hepatitis. The male ratio was strikingly high in the case of hepatocellular carcinoma. It is thought that liver cirrhosis is a cause of hepatocellular carcinoma. And then differences in the results of liver function tests between men and women were studied in the patients with liver cirrhosis. However, no remarkable difference was found between men and women.

We gathered information of both drinking and smoking habits by questionnairing. The subjects of our study were 116 men around Yanai City. They were divided into five groups. 1st: neither drinking nor smoking habits (23 cases). 2nd: 20 or 40 grams of ethyl alcohol daily and no smoking habit (31 cases). 3rd: more than 40 grams daily and more than 10 cigarettes (32 cases). 4th: 20 grams daily and more than 10 cigarettes (16 cases). 5th: no drinking habit and more than 10 cigarettes daily (14 cases).
The 1st group was a control group, and was compared with the 2nd, 3rd 4th and 5th groups. Consequently both systolic and diastolic blood pressure levels rose significantly only in the 3rd group. Only systolic blood pressure level rose significantly in the 4th group. And so it was suggested that both drinking and smoking habits raised both systolic and diastolic blood pressure levels.