This preliminary report deals with the derivation of technics for pancreozymin-secretin test and secretin test described by Sun et al. and Dreiling et al. as the exocrine function of the pancreas, and the results obtained from 40 patients without pancreatic diseases on whom such derived tests were performed. 1) The technic of pancreozymin-secretin test derived and currently employed may be summarized as follows. Pancreozymin (Boots), in a dose of 1 unit per kg of body weight, was given first intravenously and duodenal content was collected for two 10-minute period postpancreozymin followed by secretin (Boots), in a dose of 1 unit per kg of body weight, collecting duodenal content for two 10-minute period followed by two 20-minute period in total 60 minutes postsecretin. In a case of secretin test was duodenal content collected after administration of secretin in a dose of 1 unit per kg of body weight for two 10-minute period followed by two 20-minute period in total 60 minutes postsecretin. Continuous aspiration with a suction pump at a negative pressure of 250 mm of water was maintained through the cllection of duodenal content. The volume, amylase activity and bicarbonate concentration of the duodenal content collected were determined respectively. Blood sample was taken before pancreozymin or secretin was injected and at 1, 2, and 4 hours after secretin and serum amylase activity was determined. 2) Analysis of duodenal content after pancreozymin-secretin administration consists amylase output per kg of body weight 20- minute period after pancreozymin stimulation, volume output per kg of body weight, amylase output per kg of body weight, maximal amylase concentration, maximal bicarbonate concentration, and bicarbonate output per kg of body weight for 60-munute period after secretin stimulation. Secretin test, on the other hand, consists measurement of volume output per kg of body weight, amylase output per kg of body weight, maximal amylase concentration, maximal bicarbonate concentration, and bicarbonate output per kg of body weight. “Norms” of pancreozymin -secretin test and secretin test have been established by statistical analysis of the above mentioned measurement of duodenal content. 3) Serum amylase response to pancreozymin-secretin test or secretin test was considered positive when serum amylase value valied more than 35 Somogyi units after pancreozymin or secretin stimulation. 4) The results of duodenal contents in postsecretin 60-minute period of “normal” subjects in pancreozymin-secretin test did not differ from those normal values obtained after secretin alone.
Concerning the genesis of biliary dyskinesia, experimental studies of the various kinds of bacteriotoxins, the coelomic fluid of ascaris lumbricoides, cancer-toxin and the toxin of tubercle bacilli already were made in our clinic. The auther supposed that biliary dyskinesia is the cause for the toxin of brucella abortus Bang and experimented on the biliary dyskinesia of dogs. This experimental method was the third stage of our instrument. The strain of it used in the experiments was endotoxin of bacillus abortus Bang (B3 Bang). The auther observed the effects of the toxin of brucella abortus Bang on the biliary system and made dogs sensitized with the brucella abortus Bang to observe the changes of biliary systems after sensitization comparing them with those of normal dogs. Furthermore, the auther observed the grade of effect upon the biliary system of the sensitized dogs by intra venous injection of 1 ml of the endotoxin which caused little change in normal dogs. The results were as follows: 1) The results of the experiments to make it clear that the toxin of the brueclla abortus Bang stimulates the biliary system, that is, its gall bladder pressure was increased, the perfusion through Oddi's sphincter ceased and the motility of duodenum accelerated. 2) In dogs given an intramuscular injection of endotoxin, the intra venous injection of 1 ml of the toxin induced on the 3rd-5th day strong tension of Oddi's sphincter and a sensitive reaction of gall bladder. 3) The state of dogs on the 5th-7th day after the sensitization suggests that a state of hypertonic dyskinesia was produced. 4) The state of dogs on the 8th-15th day after sensitization suggests that a state of hypotonic dyskinesia was produced. From the findings mentioned above, it would be safe to state that the biliary dyskinesia is possibly caused by the allergic base due to the toxin of brucella abortus Bang.
GASTROTEST was repeated at 10 times for every 2-5 days in each of 22 normal subjects. Daily changes in gastric acidity were studied. Different result during the repeated tests was observed more than once in 18 out of 22 subjects studied. Eleven subjects were found to show different results at a few times. Five subjects, who showed free acid at 7 out of 10 times, were found to have hyperacidity with gastric tube method (Katsch-Kalk method). Two subjects who failed to show free acid at 8 and 9 times respectively, were found to have hypoacidity and 1 subject who always failed to show normal acidity after histamin stimulation. Therefore, when an acidity was indicated with GASTROTEST, we should not conclude the anacidity with only one determination. We must examine at least more than twice with GASTROTEST. Twenty one patients with some gastrointestinal diseases were examined with both GASTROTEST and gastic tube method (Katsch-Kalk method). Eighteen out of 21 patients were found to have anacidity with GASTROTEST, and 11 cases of those 18 patients, failed to show anacidity with Katsch-Kalk method. Other 7 cases were found to have free gastric acidity after IMIDALIN stimulation. The results suggest that the effect of caffein on gastric secretion is not strong enough to detect the true anacidity. The pigments excreted into urine after administration of GASTROTEST tablets are apparently different from 3-phenilazo-2, 6-diaminopyridin contained in the tablets. At least, 2 different pigments were indentified in urine with paper chromatography and spectrophotometory.
Since the first description of ulcer niche by Reiche (1909) and Haudeck (1910), there is a remarkable advantage in the field of x-ray diagnosis on gastric ulcer. Now a days, it becomes fairly easy, accompanied with a recent progress in the field of endoscopical diagnosis, not only to detect the lesion but also to demonstrate their fine details for making a differential diagnosis or for a roentgenological observation of the course of the lesion. However, the main subjects of past reported numerous studies on the x-ray diagnosis of gastric ulcer, were usually directed only to the morphological aspect of the crater of the lesion, while in a few reports the problems and x-ray findings of ulcer scar are discussed. The reason of this fact is considered to depend mainly upon the under-development of the radiographical technic. Now, the technic has improved enough to demonstrate such lesions and to discuss the following problems: judgment of the gastric ulcer whether it is healed or not, problems of recurrence or resurrection of the lesion, epidemiologic feature of gastric ulcer, differential diagnosis between ulcer scar and some type of superficial spreading carcinoma and, by any chance, pathogenetic problem of “scar-cancer”. Furthermore, Pathogenetic course of gastric ulcer itself would be clarified, if the whole course of gastric ulcer including even in its cicatrix stage could be observed roentgeno-morphologically. Objects of the study and the material The author examined the cases of gastric ulcer roentgenologically as minutely, as periodically and as long-datedly as possible, and thus tried to follow successively the healing process of gastric ulcer and the changing phases of the x-ray findings even after vanishing of the ulcer niche. Several objective points are as follows: 1) Is it possible to diagnose gastric ulcer scar roentgenologically 2) If possible, what kind of findings lead to the diagnosis, and with what degree of certainty? 3) Are several types of scar differentiated roentgenologically? 4) Is the x-ray findings of scar changing as the time passes? The materials are limited to 50 cases of round or elliptic gastric ulcer which was successfully demonstrated roentgenologically several times during an observation period intended. That is, saddle ulcer, linear ulcer, kissing ulcer and multiple ulcer are excluded. Interval of taking picture X-ray examinations on these cases, mainly by double contrast method and barium filling method, have been performed once in two weeks in their ulcerative stage and three to four times a year after vanishing of the crater for a period of one to five and half year since the first visiting of the patients.