As basic study of the gastric suction biopsy, the artificial changes of the gastric mucosa of dogs were examined, and as clinical study, the findings of gastrocamera and gastric suction biopsy were compared. The examination of gastritis distribution in the stomach by the suction biopsy was also performed. 1) Improved biopsy instruments of Henning and Tohoku University types were used. 2) Gastric suction biopsies of dogs were performed at 80, 100 and 150 mmHg. The biopsy specimens obtained at 100 mmHg contained all layers of the mucosa including muscularis mucosae. When it was compared with the surgical specimen, no appreciable change was found except the fragment obtained by the suction biopsy tended to be slightly thin. 3) It was confirmed macroscopically and histologically that the mucosa lesion produced by the biopsy in the experiment nearly healed in 7 to 10 days. In clinical cases, almost complete healing by the 10th day after the suction biopsy was observed by gastrocamera. 4) Occult blood in stool became negative in 4 days. There was no complication due to the biopsy which required any treatment. 5) As clinical study, the combined examination of the gastrocamera and gastric suction biopsy under fluoroscopy was done in 566 patients with complaints of gastro intestinal troubles. A total of 1352 biopsies were taken from the cardia, body and pylorus of the stomach with 1 to 7 specimens from each portion. 6) In the findings of gastrocamera, atrophic gastritis was classified into I-IV and + M (superficial atrophic gastritis). The pathological finding of biopsies was classified into acute gastritis and chronic gastritis. 7) In the correlation between the findings of gastrocamera and biopsies in the body of the stomach, the findings of gastrocamera as normal or superficial gastritis did not always agree in those of the biopsies. However, findings in atrophic gastritis, especially atrophic gastritis + M agreed well in those of the biopsies. 8) In the pyloric portion of the stomach, the findings of gastrocamera in normal mucosa or superficial gastritis did not agree so well as in the body of the stomach, but the findings in atrophic gastritis did show good gareement. Metaplasic change of the mucosa was found frequently in the biopsy in proportion as gastritis became worse. 9) Generally the findings of gastrocamera taken at the optical distance showed good agreement in those of the biopsies. 10) The findings by gastrocamera which had been bases for the diagnosis were analysed to correlate to the findings of the biopsy. In the cases of atrophic gastritis diagnosed as severe gastritis by gastrocamera, deformation of epithelial cells and pit, and intestinal metaplasia were frequently observed in the biopsies. 11) In the findings of biopsies from each portion of the stomach, the biopsies from the upper portion and lower portion of the body revealed similar appearance in atrophic changes in most of cases. 12) In comparison with the biopsies from the pyloric antrum and canal, similar findings were found in the great majority of cases. 13) In comparison among the biopsies from the cardia, and the upper and lower portions of the body, the similar findings of atrophic changes were found in about half of the cases. 14) In comparison with the biopsies from the body and pylorus, the similar findings were found in the great majority of cases.
100 cases of chronic alcoholics consuming daily more than 135 g alcohol were studied as to clinical history, liver function tests and histological findings. 11 cases of suggestive viral and non specific reactive hepatitis were excluded from these cases. Included were 13 hepatosis (8 fatty liver), 11 hepatitis-type, 21 fibrosis, 15 precirrhosis and 29 cirrhosis. Histological findings were as follows; 73%, hydropic swelling; 53%, perpheral necrosis and scar; and 30%, intermedial ones; 28%, nodular cell infiltration; 22%, acidophilic degeneration and 9%, diffuse fatty metamorphosis. Fatty metamorphosis was found in 3 of hepatitis-type, 7 of 21 fibrosis, 5 of 15 precirrhosis and 6 of 29 cirrhosis. However, some serial biopsy specimens showed that fatty metamorphosis was disappeared after discontinuing alcohol intake, and fibrosis was scarcely found around fatty cyst. There fore it was estimated that alcoholic fatty liver per se was less likely to cause cirrhosis. Mallry's alcoholic hyaline was found 9 cases. Vatiant extents of liver cell nccrosis and scar were found in 30 cases in intermedial or central area, and in 47 cases in periportal area. They were with collapse of reticulum network and some inflammatory cell infiltration, and appeared to lead to a destruction of the lobular architecture and to a pseudolobular formation. Serial biopsies of 21 cases showed that discontinution of alcohol intake during liver injury was a most significant factor to prevent necrosis, fatty metamorphosis and development of cirrhosis. Cirrhosis was found in 17 of 45 cases consuming between 180 g and 300 g of alcohol, and in 8 of 9 cases consuming daily more than 300 g alcohol, and, there was a relationship between the quantity of alcohol consumed and the histological findings.
Indocyanine green (ICG) may have characteristics that could make its uptake, storage and excretion by liver helpful indices of hepatic function. Author observed its physical properties, plasma decay (plasma disappearance rate: K) in hepatic diseases, “transport maximum (Tm)” and “relative storage capacity (S)”, and interferance between ICG and bromsulfophthalein (BSP). Author, also, discussed a simplified method of hepatic ICG clearance test.