In order to study the relationship between histological changes and functions of the gastric mucosa of chronic gastritis, the gastric mucosa obtained by suction biopsy was studied by a histochemical method. Enzyme activities (alkaline and acid phosphatase) of the mucosa of gastritis was compared with histological changes of the mucosa, and following results were obtained. 1) For histochemical studies of the normal mucosa and mucosa of chronic gastritis, the most suitable tissue was obtained by suction biopsy under fluoroscopy and by gastrocamera examination. 2) The best histological slide was made with a frozen section cut in a cryostadt. 3) Alkaline and acid phosphatase acitivities were investigated by the modified Gomori's method with sodium glycerophosphate as substrate. The sections were incubated for 90 minutes. 4) In the normal mucosa of the body and antrum, the surface epithelium and capillary wall revealed positive alkaline phosphatase activity and other area did negative. With appearance of superficial changes of the mucosa, however, positive activity of the capillary wall became much more evident. The surface epithelium of the antrum with atrophic gastritis revealed false positive activity. The mucosa revealed positive activity together with metaplasia. The lymph follicles appeared together with progression of atrophic changes of the mucosa and showed positive enzyme activity. On the other hand, gastric acidity was decreased with progression ofatrophic change of the mucosa, Therefore, acidity seemed to be closely correlated with alkaline phos phatase activity. 5) Acid phosphatase activity was negative in the surface epithelium of the body. But one of 7 cases showed false positive. The activity was false positive in the surface epithelium of the antrum and positive in the intestinal metaplasia. The parietal cells of the gland cells showed negative activity. The chief cells and pyloric gland showed positive. But the neck chief cells did positive or false positive. There were no remarkable changes of enzyme activities of the cells although there were some variations of activity in numbers with appearance of the atrophic change or metaplasia of the mucosa.
In order to elucidate the internal structure of gallstones, the method of super soft x-ray photography was applied to the 374 cases of cholelithiasis, and a new classification of gallstones was made based on these photographs. This method has an advantage to make the internal structure and components of the gallstones clear without breaking them. By this method, all gallstones were classified into five types. 1. Monocentric radial stones. 2. Monocentric radial, lamellar stones. 3. Multicentric radial stones. 4. Cocentric lamellar stones. 5. Others. The minute structure, especially the form and localization of calcium in the gallstones were detected in thin section of calculus using contact microradiography. (C.M.R.) C.M.R. was concluded to be better to examine the arrangement of calcium than histochemical method which might add artificial changes to the preparation.
The mechanism of portal hypertension in fatty liver and correlation between vascular changes and histogenesis of fatty liver and cirrhosis were studied. The rats were sacrificed after 1, 3, 5, 10, 15 and 20 weeks following the administration of the choline-deficient diet prescribed by György et al. Intra-hepatic vascular changes were observed by means of a preparation of liver infused with colored plastik or gelatin. Portal pressure was estimated from intra-splenic pressure. The livers of choline-deficient rats revealed the following histological changes: hepatic cells were filled with small fat droplets in one week and with large fat droplets in three weeks. During five weeks the fatty cysts were formed in the cells. In the severest cases, hepatic fibrosis and cirrhosis occurred after ten and twenty weeks respectively. Portal pressure was distinctly increased in three weeks, although a moderate decrease after five weeks was noted. Then it became gradually increased up to twenty weeks. Pronounced narrowing of the sinusoids were noted in three weeks and continued up to five weeks, although portal pressure decreased after five weeks. Later the narrowing of sinusoids became more marked. After 15 weeks, when fibrosis occurred, anastomo ses between the terminal branches of hepatic vein with occasional increase of surrounding connective tissue fiber were seen. At this stage the increase of arterio-venous anastomoses or tortuous hepatic artery and portal vein was not observed. From above findings of fatty liver in the rats, it is considered that portal hypertension was mainly attributed to compression of sinusoids by marked increase in hepatic cell volume with fat accumulation. Formation of fatty cysts probably relieved the compression of sinusoids. At the later stage of fatty liver there was no change of hepatic arterial and portal beds, although anastomoses between the terminal branches of hepatic vein were formed.
An attempt was made to investigate the correlation between intra-hepatic vascular changes and histogenesis of fatty cirrhosis in the rats fed with a choline-deficient diet prescribed by Hartroft for 1 to 6 months. Intra-hepatic vascular changes were observed by a mean of a prepara tion of the liver infused with colored plastik or gelatin solutions. Progression of fatty liver and cirrhosis was evaluated histologically by the criteria of Hoffbauer et al. Portal pressure was appraised from intra-splenic pressure. Liver cirrhosis was found in over 90% of rats fed with a choline-deficient diet for 6 months. Portal pressure showed a tendency to increase with histological progression of the liver. Distortion of the hepatic and portal veins and anastomoses between each of the terminal branches of the hepatic vein were observed in the liver having slight to moderate fibrosis (stage 3A). In the reconstructed liver by fibrous band without regeneration nodules (stage 3B), features of compression in the small hepatic and portal veins, anastomoses between the hepatic and portal veins or each of the portal veins, and disorganization of the vessels in the area surrounded by fibrous band were observed. When regenerating nodules developed in the scattered area of the liver (stage 4A), the intra-nodular vessels were compressed toward outside of the nodules, showing basket-like appearance, and this feature was prominent near by the terminal hepatic veins. When development of regeneration nodules became marked (stage 4B), conspicuous compression of relatively large vessels in the both veins, especially in the hepatic vein, was observed. Blood supply through the portal vein was preserved in each nodule. And some nodules were supplied portal blood through one terminal branch and the others were done through 2 or more branches. These results would indicate that hepatic fibrosis was preceeded by the changes in the hepatic veins, and intra-hepatic vascular changes became prominent with progress of liver cirrhosis. The differences of blood supply in each nodule may influence on futher progression of liver cirrhosis.