Endoscopic diagnosis of chronic gastritis was studied using Schindler's endoscopic classification together with mixed form. Classification of histological findings of the biopsy specimen according to the standard of Wood and Tof t was also used. After repeatedly performing this test and the comparative effect was studied in the course of the disease.Following conlusions were obtained :(1) Studies on endoscopic findings through gastric b iopsy. Superficial gastritis was found in 64% of subjects below 29 years of age, decreasing with advance in age. On the contrary atrophic gastritis increased with advance in age, being most frequent above the age of 60, 66%. Similar relationship was also found in biopsy. Changes according to age were most pronounced in gastric atrophy. The endoscopic findings were classified according to Shindler's classification with addition of mixed form. Even if the atrophic changes were classf ied into superficial, atrophic, and atrophic hyperplastic varieties, no ground for the classification by histological findings of the biopsy specimen was obtained. No histological findings confirming the diagnosis of hyperplastic gastritis was obtained. For the classification with histological findings, classification by Wood and Toft; superficial gastritis, atrophic gastritis, and gastric atrophy appears to be adequate. The rate of agreement with endoscopic findings was the highest in atrophic gastritis and gastric atrophy of 77%, followed by 59% of superficial gastritis and 43% normals.(2) Studies on pictures of gastritis in long term followup. Gastric mucosa frequently shows superficial inflammatory findings during the follow-up observation. These changes are mostly reversible. Superficial gastritis frequently changes into atrophic gastritis, which is irrevrsible. Superficial changes frequently participate the development of gastric atrophy. Such development sometimes occurs rapidly in progression, followed by a gradual progress, while a long period of standstill is also seen meanwhile.

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The material consisted of benign ulcer caces in which resection was performed within 3 days following gastrocamera examination. The resected specimens were semi-serially sectioned and compared with the gastrocamera photographs in regard to 1) the tran sectional diagram, 2) the base, 3) regenerating mucosa, and 4) marginal elevation. It should be emphasized that each view of transection was compared in detail with the corresponding part of gastrocamera photographs.1. The transectional diagram Ulcer was divided into four forms depending on the pattern of transection as follows; 1) Undermined type, 2) Right angle type, 3) Inclining type, and 4) Flat type. It was then revealed that these types could be accurately demonstrated by the gastrocamera. Compared with the histopathological findings, relationships between the above mentioned patterns and the histological depth of ulcer was analysed.2. Ulcer base Color of the base was compared with its histolcgical structure. 1) If the base is uniformly white endoscopically, the first layer of the base (the layer of exsudate) rarely contained erythrocytes, and the layer mainly consisted of leucocytes and the second layer (the layer of fibrinoid necrosis) showed minimal development. 2) When the base was uniformly dark brown or white mixed with dark brown parts, the dark brown usually represented the presence of erythrocytes in the first layer. The second layer was also well developed in these cases. 3) When the base appeared white mixed with pinkish red color, the first layer was thinn and the second layer was absent. The pinkish red portion was consistent with exposure of the third or fourth layer (the layer of granulation tissue or the layer of scar tissue).3. Regenerating mucosa The regenerating mucosa was deviled into three grades acording to the stage of development ; the regenerating epithelium only, immature regenerating mucosa, and fully mature regenerating mucosa. Then, redness as seen by the gastrocamera appeares to be related tothe grade of development. Cases showing redness tended to contain immature regenerating mucosa, and vice versa. The mature regerating mucosa was difficult to differentiate endoscopically from the adjacent mucosa.4. Marginal elevation Elevation of the ulcer margines as seen endoscopically was divided into three grades ; marked, moderate and slight, and compared with thickness of the specimen. Naturally, endoscopic and actual thickness corresponded well with each other. The thickness of the margines mainly depended upon the amount of fibrosis in the subserosal layer.5. Conclusion Based on the above findings, an attempt was made to show endoscopic characteristics of ulcers with little healing tendency and with healing tendency.

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