An endoscopic atrophic border at the lower portion of the stomach has been recognized and proved as a bounpary between the pyloric and fundic gland territories. And this also means histologically atrophy of the pyloric gland and non-atrophy of the fundic gland. But the study of sucha border in the cardiac portion has not yet been known well enough. In this report, the existence of sucha border in the cardiac portion was confirmed endo scopically by the use of Congo red method and investigated histologically by biopsy.Method After washing of the gastric mucosa with 5% sodium bicarbonate, 50cc of 0.3% Congo red solution was supplied into the stomach and 50mg of Histalog was injected intramuscularly. Then Fibergastroscope was inserted to observe a discoloring reaction at the gastric cardia and to perform biopsy under direct vision.Results By the discoloration of Congo red, a black colored zone was distinguished from a red zone, and a boundary became manifest endoscopically between them around the esophagogastric junction in all 39 cases. The patterns of this border were classified into 4 types (I-IV). Histological changes of the both sides across this border showed atrophic and inflammatory changes at the red zone, and normal mucosa at the black colored zone both in the fundic gland territory. The number of parietal cells were remarkably decreased at the red zone. So it seems to us that this border is also the boundary between atrophy and non-atrophy, but this is by no means the meaning of boundary between fundic and cardiac glands.

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There are three types of swelling of the neck which develop during peroral endoscopy. One is the swelling called Compton's pouch, which occurres at the subman.dibular region. This swelling is presumed to be due to air distention of blind Branchial cleft remnants. Gagging and retching by the patient during endoscopy are thought to force air blow into the remaining pouches of Branchial clefts. Compton's pouch is clinically insignificant other than demonstration of the presence of these vestigial remnants. This swelling is not so firm and can easily be sqeezed flat, or left alone, it deflates spontaneously in about half or one hour. This is very rare complication and we have experienced only a few times for the last several years. Second type is produced by the distended or displaced submaxillary salivary gland. This occurres almost at the same place as Compton's pounhh and is also symptomless, but this type of swelling is relatively firm and cannot be deflated by pressure. This may disappear spontaneously in 2 to 12 hours. This is also rare, but we experienced two caces of swelling thought to be of this type. The swellings in both two cases occurred during esophagoscopy. In one of them it occurred two times. The exact incidence is probably 0.05%, since we experienced three times in about 6, 000 esophagoscopic examinations. The last type is the swelling which is seen at the preauricular area and is thought to be the swelling of the paroticl gland. This may be producedd in the same way as the submaxillary salivary gland swelling judging from it's nature. This is also rare, occurred only a few times seen in one case in the course of about 50, 000 peroral endoscopies performed by the authors.

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Various reports have been described about occurren-ces and clinical signif icances of hezoars in the gastric remnant. Recently we experienced two cases of bezoar in the operated stomach. One was a case of which a bezoar might be produced of residua of food conglo-merated around suture threads exposed from the stoma of the Billroth-II operated stomach. In this case, suture threads were tought to be the important factor of the bezoar formation in addition to the various factors ever thought such as gastric stasis of food, delayed emptying or decreased gastric secretions. This bezoar disappeared through cutting the thread by biopsy forceps. In the other case, a rather large bezoar was found in the postgastrectomized stomach through the Billroth-I method. Erosions and superficial gastric changes obser-ved around the portion of anastomosis were found to improve shortly after when the bezoar disappeared after crushing in pieces by biopsy forceps endoscopically. This fact might show that bezoars would have some effects on the gastric mucosa.

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Recent progress in colonof iberscope has made the possible understanding of the direct observation on the entire colon, following the remarkable improvement on the diagnosis of the lower bowel. In some cases, however, it is difficult to introduce the scope into the right sidded colon because of the extension of the sigmoid colon, which prevents from the sufficient arri-val to the lesion. We deviced a overcoat-tube of the scope for pressing clown the extension of the sigmoid colon. In directly leading the inserting force to its tip, this tube aids the scope in reaching into the caecum with ease and shortly. A "sliding tube" we named, is an elastic tube which is 1.5 and 2.0 cm in an inside and an outside diameter and is 47 cm in length. We have applied the "sliding tube" to 28 cases and obtained some statisf actory results. This paper shows the frame and the method of the tube and the results of the cases we used.

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