Our results indicate that although HCV infection can be self-limited or associated with ESLD, the majority of adults have persistent viremia without clinically demonstrable liver disease. Further research is needed to explain the less frequent clearance of HCV infection among black persons and to improve utilization of treatment for those infected in the context of injection drug use. JAMA. 2000;284:450-456

The mechanisms that permit adult tissues to regenerate when injured are not well understood. Initiation of liver regeneration requires the injury-related cytokines, tumor necrosis factor (TNF) ␣ and interleukin (IL) 6, and involves the activation of cytokine-regulated transcription factors such as NF-␤ and STAT3. During regeneration, TNF␣ and IL-6 promote hepatocyte viability, as well as proliferation, because interventions that inhibit either cytokine not only block hepatocyte DNA synthesis, but also increase liver cell death. These observations suggest that the cytokines induce hepatoprotective factors in the regenerating liver. Given evidence that nitric oxide can prevent TNF-mediated activation of the pro-apoptotic protease caspase 3 and protect hepatocytes from cytokine-mediated death, cytokine-inducible nitric oxide synthase (iNOS) may be an important hepatoprotective factor in the regenerating liver. In support of this hypothesis we report that the hepatocyte proliferative response to partial liver resection is severely inhibited in transgenic mice with targeted disruption of the iNOS gene. Instead, partial hepatectomy is followed by increased caspase 3 activity, hepatocyte death, and liver failure, despite preserved induction of TNF␣, IL-6, NF-␤, and STAT3. These results suggest that during successful tissue regeneration, injury-related cytokines induce factors, such as iNOS and its product, NO, that protect surviving cells from cytokine-mediated death.

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Recurrence of primary sclerosing cholangitis (PSC) after liver transplantation is very uncommon. The true incidence of recurrence is unknown, mainly because of the difficulty in differentiating ischemic strictures from that of recurrent disease. Primary sclerosing cholangitis and ischemic strictures have identical histopathologic and cholangiographic features. We report a young man who had recurrence of PSC in two allografts and report our experience in 32 patients who had liver transplantation for PSC. Six patients (18%) had evidence of non-anastomotic strictures and, of these, only one patient (reported here) had unequivocal evidence of true recurrence. The strictures in other five patients happened because of ischemia. The recurrence of the disease in two allografts in an immunosuppressed patient, in the absence of ischemia, chronic rejection, or any known pathogen, raises the question of the role of an unidentified infectious agent in the etiopathogenesis of PSC.

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SINcE vitamin C was identified with ascorbic acid several attempts have been made to assay the vitamin in foodstuffs by modifications of Tillman's dichlorophenolindophenol titration method. Bacharach et al. [1934] by examining oranges, tangerines and lemons found that vitamin C was present in gradually diminishing amounts from the skin inwards and they suggested that vitamin C was photosynthesised at the skin. A systematic investigation of a large number of foodstuffs was undertaken in this laboratory in order to ascertain the distribution of vitamin C in different parts of the foodstuff. Bessey and King [1933] and Birch et al. [1933] give methods of extracting the vitamin from foodstuffs for titration with the indophenol reagent. The author used the following modified method in order to obtain strictly comparable results. 5-10 g. of the substance, or as much as is available, are taken in a mortar and 10 ml. of 20°t richloroacetic acid are added. The mass is then ground into a fine paste with clean sand previously treated with acids, washed and dried. The pasty mass is then stirred up with water and filtered on a Biichner funnel with suction. The residue is transferred to the mortar, 2-5 ml. of trichloroacetic acid are added and the mass is ground up and filtered. The residue is washed 2 or 3 times with water and the combined filtrates made up to 50 ml.; 0-5 ml. of the dichlorophenolindophenol solution (M/100 approx.) is taken and 10 ml. of glacial acetic acid are added following upon the observation of Ghosh and Guha [1935] that the addition of the acetic acid inhibits the decolorising action of trichloroacetic acid. The red solution thus obtained is then titrated with the filtrate from a burette until the dye is decolorised. The titration is timed by a stop-watch and is finished in about Ij min. The dye is next titrated with a solution of ascorbic acid, at about the saIne rate. The ascorbic acid is finally titrated with N/100 iodine solution.Generally the ascorbic acid contents of the skin and the flesh of fruits and vegetables have been assayed. In some cases the ascorbic acid content of leaves and in two cases that of the seeds have also been determined. It will be seen that in all cases the ascorbic acid is more concentrated in the skin than in the flesh (Table I). The result thus confirms the finding of Bacharach et al. It was expected that the leaves of the root vegetables would give higher values than the skin or the flesh and this expectation was realised except in the case of the radish where the difference is within the experimental error.Quite recently Ranganathan [1935] reported that he bad confirmed the results of Bacharach et al. in some but not in all cases. McHenry and Graham [1935] also found that in cucumber the ascorbic acid was more concentrated in the skin than in the flesh, but in turnip the reverse was the case, and theyadvanced an argument to explain this apparent discrepancy. We have, however, failed to ( 701 )

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