Using one or two capsules with different frequency, the author studied the relationships between the pH values of the stomach and the duodenal bulb and between the remnant stomach and the efferent-loop. The subjects were 116 cases: 7 healthy, 55 with gastro-duodenal diseases, 54 casesafter partial gastrectomy (including 11 cases of stomal ulcer). The results obtained were as follows: 1) Generally, in the fasting state, the gastric pH was stable, and, on the other hand, the duodenal bulbar pH fluctuated remarkably and periodically. 2) In the healthy person, the gastric pH was around 1.8, and the bulbar pH descended from the value around 7.0, as a base line, to the value 2.5, as the lowest line, fluctuating about 9 times during 10 minutes. 3) In the duodenal ulcer cases, the average of the gastric pH was 1.5, and the bulbar pH from 6.3 to 2.0 The pH fluctuation curve in these cases was quite defferent from that of the healthy. 4) The pH curves of the bulbus were classified into 3 types: The lst type represents a sharp fluctuation, the 2nd type a gradual fluctuation, the 3rd typea slight fluctuation or no fluctuation.The lst type in all the healthy, the lst and the 2nd types in most of the gastric ulcer cases, the 2nd and the 3rd types were found in most of the duodenal ulcer cases. 5) The duration in which the bulbar pH remained below 4.0 during 10 minutes was summed (ΣT).The lower the gastric pH was, the lower the bulbar pH was, and the ΣT also became longer.There was no fluctuation of the bulbar pH when the gastric pH was above 4.0. 6) The pH in the post-bulbar part was stable with no relation to the gastric pH value. 7) The pH in the most remnant stomach 3 months after gastrectomy, were below 3.1 or above 5.0. 8) The in fluence of the remnant stomach content upon the pH values in the effeerent loop was found from the stoma to the part of about 5 cm distance. 9) In 10 of the 11 cases of the stomal ulcer, the pH of the remnant stomach were below 2.0. 10) All the cases with stomal ulcer were diagnosed by gastro-fiberscope.
The present study was designed to investigate some role of hepatocytes and mesenchymal cells in the process of resorption of collagen fibers in experimental hepatic fibrosis. The exprolatory laparotomy was performed on the female Wistar strain rats, which had been subjected to subcutaneous injection of carbon tetrachloride for 4 to 12 weeks, to get a small piece of liver tissue for morphological and enzymohistochemical study. Carbon tetrachloride administration was discontinued, and 1 to 3 weeks thereafter the animals were sacrificed. The broad fibrous septa in the liver as a result of the continued carbon tetrachloride administration were rarefied and collagen fibers proliferated around degenerated hepatocytes, especially in the perisinusoidal spaces, has almost disappeared 3 weeks after the discontinuation of carbon tetrachloride administration. The hepatic cells facing to the site of collagen fiber proliferation showed a flattening and/or disappearance of microvilli and irregular deposition of ruthenium red positive material coating hepatic cell surface. The organelles of these hepatic cells appeared degenerated with a marked decrease of primary lysosomes. These abnormal findings have disappeared in almost parallel with the disappearance of the newly formed collagen fibers as well as ruthenium red positive material. The enzymohistochemical study revealed a markedly decreased activity of lysosomal enzymes both in hepatocytes and mesenchymal cells in the advanced stage of hepatic fibrosis. In the recovery stage the enzymatic activity in the hepatocytes and mecenchymal cells appears almost normal. Ultrastructural findings suggested that the collagen fibers would be degraded mainly in the extracellular process, and some fibers first degraded extracellularly to a certain extent would be engulfed by Kupffer cells and/or macrophages. It is surmised that the fusion of the primary lysosomes with the phagosome which has enveloped the degraded pieces of collagen fibers will accelerate the decomposition and hydrolysis of the denatured collagen.
1. Abnormal cholecystogram was found in 21% of 866 cases examined for routine physical examination performed in Keio University Hospital. Silent stone of the gallbladder was found in 1.6% of the cases. The incidence of abnormalities increased gradually with age. In admitted patients biliary diseases increased related to ageing. Cancers of biliary tract appeared after fifty years old statistically and the high incidence (13.5-16.5%) of the cholelithiasis of respective age groups from fifty to seventy years old. 2. The statistic correlation between diabetes mellitus and biliary diseases were observed from the study of 10, 178 admitted patient including 445 diabetes mellitus, but no correlation existed between serum cholesterol and obesity. The abnormalities of lipoprotein fraction with increased β-and decreased α-fractions and fatty change of the liver (50%) of biopsied cases also indicated metabolic disturbance in biliary diseases. 3. The means of sizes of gallbladder in X-ray are slightly elevated in female over fourty yeares old, but not in male. Gallbladder bile collected from 36 autopsied male without biliary and hepatic diseases were examined. The content of total bilirubin, total bile acids and total cholesterol decreased in aged patients, but the ratio between cholesterol and bile acids revealed no tendency related to age. The results indicated hypofunction of concentration of the gallbladder in aged men. 4. Histological change of fibrosis with elastosis in aging existed in biliary tract and the change was most marked in the gallbladder. Portal fibrosis and elastosis were more prominent with the age and especially marked in cases with dilated bile ducts. Elastic fibers were increased around the dilated bile ducts, in the wall of the portal vein branches, hepatic vein tributaries and tortuous hepatic arteries. A duplication of internal elastic lamina was noted in cases of the aged with markedly dilated biliary trees. 5. The width of choledochus of intravenous cholecystogram showed dilatation in aged patients with biliary diseases, related to high incidence and degree of abnormal liver function test (Alkaline phosphatase, SGOT, SGPT elevation). 6. The dilatation of the choledochus were ovserved in cases of one third of duodenal diverticuli and post-gastrectomy. Hypotonic duodenography performed on patients with choledochal dilatation showed abnormal pictures of Vater's ampulla in over 80% of fifty nine cases, such as parapapillary diverticulum, papillary deformity and swelling. 8. As a conclusion the close relation between age and biliary tract diseases are observed from statistical, radiological, biochemical and histological aspects.
The present report describes the results of serum Au-antigen and Au-antibody determinations in 7337 patients visited Kure National Hospital to examine the liver function tests from June of 1970 to the end of October of 1971. The results obtained are the followings; 1) 47 of 458 subjects who were transfused, including 11 with Au-antibody and 7 with Auantigen, were diagnosed to be transfusion-associated hepatitis. 2) In 11 cases with Au-antibody positive hepatitis, in whom 9 may be classified as MS-1 type hepatitis, mean incubation period from initiation of transfusion was 29.8 days. 3) On the other hand, 38 patients without Au-antibody, including 13 cases of MS-1 type hepatitis and 25 remainders of MS-2 type hepatitis respectively. have 57.9 days of mean incubation period. 4) From above results, authors would like to describe two types of posttransfusion hepatitis, namely. MS-1 and MS-2 respectively. Furthermore, it is prophylactically interesting that Au-antibody seems to be able to prevent the development of MS-2 type hepatitis but not MS-1.