The dye scattering method is one of useful methods to observe gastric mucosa in detail endoscopically. In reading the endoscopical picture with dye scattering method, it is necessary to know the characteristics and the effects of this method. In order to investigate the difference in endoscopic view between dye scattering method and normal method, the dye scattering method was performed in 252 cases. 1) The dye scattering method is more effective to recognize the existence of ulcerous changes in the stcnmach. 2) It is easy to decide the stage of gastric ulcer correctly using this method, 3) The merit of this method is not only to observe the minute appearance of gastric mucosa easily, but also to recognize the existence and the extent of redness clearly.4) Comparing the dye scattering method with normal method, the effects of this method are investigated statistically by means of giving points depend upon the degree of clearness of endoscopic findings. i) Without distinction of stages and findings, endoscopic view with this method are more clear than that with normal method. ii) The degree of the effects of this method vary in strength according to findings. Six findings and the order are as follows. fine relief <conversing folds, appearance of whitish coat, surrounding redness, surrounding edema<existence of whitish coat iii) It is also the same conclusion as i) among four findings which are necessary to decide the stage of ulcer, (whitish coat, edema, redness and conversing folds). As described above, the dye scattering method is the excellent and effective one to observe the gastric ulcer in detail endoscopically. With this method the endoscopical diagnosis of gastic ulcer becomes to be accurate, it is valuable especially in distinguishing early gastric cancer from benign ulcer. This method is not difficult and does not take long time to perform, so this method should become the routine of particular-endoscopy on gastric ulcer.

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Twenty cases of duodenal ulcer were studied on the distribution of the immunoglobulin in the biopsy specimens by immunohistochenical and immunoquantitative method, and the following results were obtained. 1) IgA, IgM, IgG, and the secretory component in each stage of duodenal ulcer were studied, more IgA-containing cells were observed in the active stage and had generally strong specific fluorescence, its leakage into the lamina propria and the stroma was recognized and it returned to the normal level following to modification. 2) IgM containing cells decreased in the active stage and increased in the scarring stage. 3) IgG containing cells stayed unchanged in each stage, and the specificity of fluorescence in the propria mucosa was strong. 4) In the active stage, the specificity of fluorescence of the secretory component decreased and was not observed in some epithelial cells. 5) IgM and IgE of the serum immunoglobulin increased and IgA decreased in the active stage. 6) The changes described above suggest the possibility of duodenal ulcer as immune disease.

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The pathophysiological approach of the atrophic border in chronic gastritis has been made by means of dying endoscopy, magnifying endoscopy and others. In this paper, discussions were made on the association of serum gastrin and gastric mucosal atrophy. Serum gastrin, in both of during fasting and after loading of the meat extract, was estimated by radioimmunoassy. There was not a significant difference in normal subjects and patients with duodenal or gastric ulcer. Fasting serum gastrin, and maximum amount and response pattern after loading proportionaly related directly to the atrophic grade of the pyloric gland area. Concerning to the atrophic border, serum gastrin increased in proportion to the elevation of the border to the fundus in closed type by Kimura and Takemoto's classification. While, in open type, serum gastrin level generally tended to decrease.

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Sixty cases of gastric carcinoma in young people less than 30 years of age were experienced, and 10 out of 60 cases were early gastric carcinoma. The lesion was mainly presented at the angle or lower corpus, which was usually called M. Macroscopically all cases were depressed type in our experiences, and protruded type was never found out. In 50 cases with advanced gastric carcinoma, Borrmann II and N were predominantly seen. Gastric carcinoma in the young has two main problems such as poor prognosis and difficult diagnosis, therefore we studied on its diagnostic probabilities using Swan-type Double-bending Gastrofiberscope, the dye contrast method and jumbo particle biopsy. In histological examination, the usual biopsy-specimens were not so sufficient for accurate diagnosis about the infiltration of the cancer cells. Therefore we prepared 4 kinds of forceps with different size, wih an aim to get much more reliable tissue for the diagnosis. As one of the methods of early diagnosis of gastric carcinoma in the young, the significance of the dye contrast method was evaluated, because we could observe the fine gastric mucosal structure and area gastricae of the lesion such as cancerous erosion and submucosal invasion by means of this method.

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The cancer in the upper stomach was observed in 14 (5.4%) out of the 260 cases of early gastric cancer and 29 (10.4%) out of the 280 cases of advanced gastric cancer. Frequency of complaints was higher in the cases of the upper gastric cancers as compared with the cancer of the other parts of the stomach.Half of the early cancers in the upper stomach were diagnosed at the first examination, but the rest were overlooked and followed. These follow-up cases were diagnosed at the second or the third examination which was done six to twelve months after the first examination. Though the first X-ray and endoscopic films were reinterpreted, any finding of cancer was not observed. From such experiences, it was considered that the early diagnosis of the upper gastric cancer was difficult, because findings of cancer on the upper part of the stomach hardly be depicted by either X-ray and endoscopic examination. After our investigation with the precise X-ray examination on upper gastric cancer, it was found that both double contrast method of upper part of the stomach in the half standing or upright position and the photographic method at the moment of barium passing over the cardia were useful to obtain significant pictures of the cancer in the upper part of the stomach.

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A 35 year-old female was admitted to our institute in March 1977, complaining of lower abdominal pain. Barium enema and endoscopic examination of the colon revealed Borrmann H type advanced cancer of the sigmoid colon, and mucosal bridges were seen continiously from the part of this cancerous lesion to upper region of rectum. The resected specimen showed "sea wrack appearance" composed of numerous mucosal bridges in anal side of the cancerous lesion, while no abnormal findings in oral side of the cancerons lesion. Histological study demonstrated tubular adenocarcinoma with invasion to serosa, In mucosal bridges, only edema and infiltration of a few round cells were seen in the proper mucosal, and submucosal layer. Discussions are made in reference to pathogenesis of mucosal bridge and relationships between inflammatory polyp and adenocarinoma.

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Volvulus of the sigmoid cnlon is not rare, however, the choice of treatment had been a matter of controversy. In 1947, Bruusgaard reported a new reduction method to treat for non-gangrenous loops using a proctoscope. Because of the success rate of his non-operative technique, proctoscopic reduction was confirmed its effectiveness and relative safety of the treatment of acute volvulus as the initial therapeutic approach. We also succeeded the non-operative reduction of volvulus by means of a flexible sigmoidoscope. A 45 years old female was admitted to our hospital complaining of severe sense of fullness and abdominal pain. A plain x-ray picture of the abdomen revealed a chracteristic grossly-distended U-shaped loop of the sigmoid colon, apparently filling the abdomen, and a diagnosis of volvulus of the sigmoid colon was established. A flexible sigmoidoscope (TCF-ls, Olympus) was inserted immediately, inspite of a proctoscope, and stenotic colonic canal was observed in the distance about 20cm from the dentate line. -However, no endoscopic findings such as inflammation or necrosis were inspected in this stenotic area. Then the sigmoidofiberscope was introduced slowly passing through the stenotic area and reached to the marked distended sigmoid colon. Aspirating gass and fecal materials, volvulus of thee sigmoid colon was endoscopically reduced easily.

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