50 fresh materials of dissected duodenum and 302 clinical cases of X-ray films showing papilla Vateri were utilized to know the pathological findings at the portion. The results are as follows. 1. The papilla, clinically defined, should include the neighbouring longitudinal fold, as well as the anatomical duodenal papilla. 2. Radiographically the papilla had a variety of forms and it was classified into five fundamental types in view of the variation in the longitudinal fold and the common duct opening. 3. Through this classification a correlation was shown between the type of papilla and the form of opening or the incident angle, of bile and pancreatic duct. 4. The papilla was abnormal if its diameter was longitudinally bigger than 15mm in type 1, bigger than 8mm and 13mm, in type II and III respectively. The transverse diameter in these cases tended to be longer than 7mm. 5. The abnormal papilla was encountered in the bile duct and pancreatic diseases, especially in choledocholithiasis, cholecystitis without stone and postcholecystectomy syndrome. 6. The maximum diameter of bile duct was broadened in the case of abnormal papilla and its terminal portion was radiographically strictured, thus Vaterian bile duct became longer than in the normal case. 7. Histological finding of the abnormal papilla was suggestive of proliferation of connective tissue there. 8. The abnormal papilla may possibly be the X-ray expression of papillitis. 9. The X-ray finding of herniated stone at the papilla enabled us to make correct diagnosis by its specific feature. 10. To diagnose the cancer of ampulla region radiographically, the understanding of the fundamental types of papilla and its strict expression and careful reading are imperative, as well as the consideration of size and form of the papilla.
The authors examined 4, 245 patients received in the Kure National Hospital and 318 samples of preserved blood were determined as Australia antigen in relation to diagnosis of hepatitis from the beginning of February to September in 1970. A positive reaction to Australia antigen was observed in 78 of 4, 245 cases and three out of 318 samples of preserved blood. Nine of 78 cases were diagnosed and confirmed as acute hepatitis. Two of 9 subjects who were diagnosed to be acute hepatitis, had past records of blood transfusion relating to hepatitis. In another 30 of 78 subjects, the liver function tests were made and found to be entirely normal and the history of blood transfusion was noted in 4 of these 30. The remaining 30 cases were diagnosed and proved to contract chronic hepatitis and recrudescence of serum hepatitis. In seven cases of acute hepatitis without any record of blood transfusion in which Australia antigen were determined in serum, Australia antigen could be observed only in one to three weeks from the initial examination. Furthermore, it is pointed out, from the observation of the severe stage of acute hepatitis, that the patients who showed a positive reaction to Australia antigen seemed to have had a more prolonged course than the negative. Studying the residential distribution of Australia antigen positive patients, it is indicated that the results obtained were very similar to those of the patients of bacillary dysentery and its carriers, with exception of the patient isolated in the area with the complete sewerage.