A comparative study about plasma gastrin response to test meal was performed in contrast to gastric acid secretion and gastric emptying among the patients with gastric ulcer, duodenal ulcer, erosive gastritis, atrophic gastritis and normal subjects.
The patients with erosive gastritis and atrophic gastritis showed significantly higher integrated increments in plasma gastrin responses than normal subjects. The patients with duodenal ulcer and gastric ulcer showed rather low integrated increments in plasma gastrin responses although statistically significant differences were not observed as compared with normal subjects. But the value of standard deviation was considerably large in each disease. It was considered that this fact suggested the complexity of the physiologic condition of each disease and the patients had to be divided into some groups by various items in each disease. The patients with atrophic gastritis was divided into two groups by fasting gastrin levels: the patients whose fasting gastrin levels were more than 150pg/ml showed significantly higher plasma gastrin responses to the meal than the patients whose fasting gastrin levels were less than 150pg/ml. The patients with duodenal ulcer who had erosive gastritis showed significantly higher responses than those who had not erosive gastritis.
No particular correlation was observed on the whole between plasma gastrin response to the meal and gastric acid secretion or gastric emptying.

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In order to elucidate the gastric emptying and the intestinal propulsion, the auther administered physiological saline, fat emulsion, glycine solution and glucose solution into the stomachs of conscious rats and examined the effects of gastrin, secretin and motilin on the gastrointestinal propulsion utilizing the chromium-51 method. When 0.5ml of physiological saline was administered into the stomach, the accelerated gastric emptying was confirmed with statistical significances at the doses of 0.4 and 4μg/Kg of gastrin, 4U/Kg of secretin and 400 and 1000ng/Kg of motilin. On the other hand, the delayed intestinal propulsion was gained at the dose of 40U/Kg of secretin, but the accelerated propulsion was confirmed at each dose of motilin. When 2.5ml of liquids were administered, the gastric emptying of physiological saline was most accelerated, and that of glucose solution was more delayed than that of glycine solution. When 2.5ml of fat emulsion were administered, the gastric emptying was delayed extremely. No effect of motilin on the gastric emptying was observed and the effects of gastrin and secretin were so various when 2.5ml of liquids except physiological saline were administered. Consequently, it is concluded that the effects of these gastrointestinal hormones on the gastrointestinal propulsion are changed by the variety and the volume of liquids administered into the stomach.

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We made lesions which resembled those of ulcerative colitis in rabbits and tried to clarify pathogenesis of the disease by studying the lesional tissues at the large intestine histologically together with immunological approach.
Rabbits with an average body weight of 2kg were chosen as objects of the study. They were sensitized with 1% physiological saline including λ-degraded-carrangeenan. After 1 week, 0.5% water solution including λ-degraded-carrageenan was given them as drinking water for about 6 weeks.
Diarrhea and loss of body weight were seen in the 2nd week of the start of the trial, and bloody stool was observed in 80% of them in the 6th week. Endoscopically, edema was observed in the 2nd week and disseminated erosion and ulcer (ul II) were found in various parts of the large intestine in the 6th week. Histologically, mucosal atrophy, small erosion, cellular infiltration with lymphocytes and plasma cells were seen remarkably in the ulcerative regions and cryptitis was also observed. PHA response was lowered gradually with the time compared with that before the administration of carrageenan in some cases and remained unchanged in other cases. We concluded that immunological mechanisms play and important role in formation of non-specific inflammatory lesion on the mucosa of experimental model, in addition to the direct action of carrageenan.

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The incidence and characteristic features of extra-intestinal complications were examined in 64 patients with ulcerative colitis. The mean incidence was 70%, but the incidence in patients with total colitis was significantly higher than that in patients with proctitis (76% VS. 33%; P<0.05). Impaired liver function was found in 15.6% of the patients and was related to the extent and the duration of colitis. Thrombophlebitis, the serious complication of the disease, occurred in the recovery stage from the severe, total colitis. Hyper-LDH₅, hyperamylasemia and/or hyperamylasuria were common laboratory abnormalities and they returned to normal level with the improvement of the colitis. Hyperamylasemia and/or hyperamylasuria occurred more frequently in severe colitis than in mild colitis (P<0.05) and they seemed to relate with the extent of involved area. Referring to the reported causes of complications, we concluded that ulcerative colitis should be regarded as a systemic disease accompanying multiple immunopathy.

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Osmotic fragility of erythrocytes in hepatobiliary diseases was examined using coil planet centrifuge system. Start point (HSP) and end point (HEP) of hemolysis correlated well and were shown to be deviated to hypoosmolar side especially in liver cirrhosis, liver cancer, and malignant biliary obstruction. The hemolysis patterns were divided into L, M, T, and R types and there was close correlation between hemolysis patterns and the degree of hepatic disturbances. In acute hepatitis hemolysis patterns took R type in its active stage and assumed L type in its convalescence. In chronic hepatitis or liver cirrhosis the hemolysis band was commonly of M or T type. The hemolysis band became R type with the right shift of HEP in liver cancer. In obstructive jaundice the hemolysis band became wider with a plateau at its peak (T type). Thus, the analysis of hemolysis patterns together with the shift of HEP was thought to be useful in the understanding and evaluation of the prognosis of hepatobiliary disorders.

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Pancreatic endocrine function during oral glucose tolerance test was investigated in patients with liver disease and in normal control.
The results obtained are as follows:
1) Significantly higher increases of blood sugar following glucose administration were commonly observed in various liver diseases as compared with that of normal control, showing the highest values in liver cirrhosis and high values of blood sugar in chronic hepatitis as compared against that in acute hepatitis.
2) plasma insulin levels also showed the same increase as blood sugar after glucose administration. Elevated plasma glucagon in a fasting state in various liver diseases decreased gradually following glucose loading, but significantly higher levels were maintained during oral glucose tolerance test as compared with that of normal control.
3) The molar ratios between insulin (I) and glucagon (G) showed an increase in acute and chronic hepatitis after glucose loading. A decrease in values, however, was observed in liver cirrhosis at 30 minutes after glucose administration as compared with that in normal control.
4) Responses of plasma insulin and glucagon to glucose administration in chronic active hepatitis were significantly higher than that in chronic inactive hepatitis. The I/G molar ratios were lower at 30 minutes in the former and higher from 60 to 120 minutes in the latter after glucose loading.
5) Responses of plasma insulin to glucose administration in decompensated liver cirrhosis was significantly lower than that in compensated liver cirrhosis, but plasma glucagon was inversely higher in the former than that in the latter. The I/G molar ratios in decompensated liver cirrhosis were lower than that in compensated liver cirrhosis after glucose administration.
From the results thus obtained in which the responses in plasma insulin and glucagon to oral glucose administration and changes of I/G molar ratios observed, corresponded to the disease status, compared with those in normal control, it was conjectured that the abnormalities in the pancreatic endocrine function might be closely related with glucose intolerance in patients with liver disease.

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The clinicopathological study of 37 cases of adenomyomatosis (localized type) of the gallbladder is described. There were 21 male and 16 female patients. Their ages ranged from 33 to 88 with an average age of 57.2 years. The cholecystographic examination revealed a round or semilunar-filling defect in the fundus in only five cases. The lesions were located in the fundus and appeared macroscopically as a circumscribed, sessile nodule with or without a central umbilication. Their sizes ranged from 7 to 17mm in diameter on histologic sections. The microscopic features of the lesions were basically composed of glandular structures and bundles of connective tissues and smooth muscles. In the mid-portion of the lesions, tissue sections showed villous mucosal hyperplasia and adenomyomatous lesions within the muscle layer and subserosal layer. In the peripheral portion, on the other hand, they revealed only adenomyomatous lesions within the subserosal layer.
Cholecystectomy was carried out in 37 cases. All patients have been doing well since surgery.

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The dissolution of radiolucent gallstones was studied in 27 patients who were given 150mg, 300mg or 600mg of ursodeoxycholic acid (UDCA) per day during over 6 months. The gallstones completely disappeared in 6 cases (22.2%) and reduced in size and/or in number in 6 cases (22.2). In no-dissolved cases who were given UDCA over 12 months, gallstones did not reduce in size and/or in number by more long term treatment.
Total bile acid in serum increased to 3.8±5.24μg/ml (mean±SD, n=13) and UDCA occupied 54.2±15.9% after treatment, whereas it occupied 6.2±5.6% of total bile acid before treatment. Lithocholic acid (LCA) did not reveal in serum. An unknown compound was detected in serum of all cases after treatment by gas-liquid chromatography and the amount of this compound increased with increasing dose of UDCA. This compound was also detected in urine of treated patients and suspected as UDCA associated substance. In bile the ratio of UDCA to total bile acid increased significantly after treatment and the lithogenic index decreased. LCA in bile was slightly increased, but not significant. There was significant correlation between the lithogenic index and the UDCA ratio.
Serum cholesterol level increased in 7.1% and serum triglyceride level decreased in 7.7% after treatment, but not statistically significant.
Standard liver function tests remained normal during the treatment.

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In order to produce experimental carcinoma of the canine biliary tract, 5-10ml of 0.7-1.0mg/ml solution of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) was administered through tube cholecystostomy every day for a maximum period of 180 days in 18 mongrel dogs.
Carcinomas of the bile duct developed in all of 7 dogs which survived more than 345 days after the start of the ENNG administration. Most of these carcinomas developed in the common bile duct and had a tendency of developing in multiplicity. Histological type of the carcinoma was papillary or tubular adenocarcinoma, with high incidence of neural invasion in the duct wall.
The mode of development of these carcinomas could be divided into 2 types: 1) polypoid type, projecting into the bile duct lumen, and 2) infiltrating type, invading deeply into the bile duct wall. As for the histogenesis of the carcinomas, the polypoid type appeared to originate from adenomas, while the infiltrating type develop as de novo cancer.

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By using the homogenate of dog pancreas, catabolism of phosphate was studied in the destructed tissue. Phosphate was very high in concentration in the pancreas tissue. The fraction of acid insoluble phosphate consisted of nucleic acid-P and lipid-P, and these values were 201.1μg (54.9%) and 61.8μg (16.9%) per 100mg of pancreas tissue respectively. Acid insoluble phosphate was changed into acid soluble phosphate, finaly into inorganic phosphorus (H₂PO^-₄), in 24-hour incubation at 37°C.
The amounts of inorganic phosphorus of the duodenal juice collected at performance of pancreozymin-secretin (PS) test was ordinaly after 24 hour incubation at 37°C, and its value of the secretin phase was 10.0±3.7μg P/ml in normal subjects (n=35). In the patient suspected to be chronic pancreatitis, the value of inorganic phosphorus of the duodenal juice was compared with three factors of PS test (volume, maximum bicarbonate and amylase output) and the findings of endoscopic retrograde pancreatography (ERP). Abnormal findings of ERP were frequently observed even in the patient with normal PS test. On the contrary, the patient with abnormal ERP findings was abnormal in concentration of inorganic phosphorus of the duodenal juice.
However, inorganic phosphorus increasing in the duodenal juice was thought to originate from the contamination with bile and/or mucosal juice, and so it was necessary to investigate pure pancreatic juice.

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292 cases undergoing various operations (thoracic surgery: 74 cases, abdominal surgery: 56 cases and others: 162 cases) were investigated in order to clarify the nature and the mechanism of postoperative hyperamylasemia by analyzing serum amylase isoenzyme and determining amylasecreatinine clearance ratio (Cam/Ccr).
56 out of 292 cases (19.2%) showed postoperative hyperamylasemia: 10.7% were the pancreatic-type hyperamylasemia and 89.3% the salivary-type. Although the salivary-typehyperamylasemia occured following any type of operation, the pancreatic-type hyperamylasemia was found only following the surgery of pancreas itself or its adjacent organs.
Incidence of postoperative hyperamylasemia and the degree of the elevation of serum amylase activity were remarkably higher in patients undergoing thoracic surgery than in those undergoing other types of operation. However, no correlationship was found between the serum amylase activity and the doses of isoproterenol given or extracorporeal circulation time.
The normal lung tissues were revealed to have some amounts of salivary-type amylase activity and the transient salivary-type hyperamylasemia was accompanied with acute respiratory distress. These facts strongly suggest the close relationship between amylase contained in the lung tissues and the salivary-type hyperamylasemia following thoracic surgery.
Significant elevation of Cam/Ccr was observed in all cases with the pancreatic-type hyperamylasemia, while no significant change was found in the salivary-type hyperamylasemia following operation.

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358 patients with various abdominal complaints were examined by upper gastrointestinal series (UGI), to which a few films taken in strong right anterior oblique projection or lateral view were added. Eighty six cases of the 358 were found to have various types of depression sign on the upper part of the stomach, 65 cases of the 86 were proceeded to ERCP studies, which revealed 5 cases of pancreatic carcinoma (4 at the body and one at the head). In addition, 7 cases who had marked abnormalities in pancreatic duct and a case with cystic dilatation of the main pancreatic duct were found.
These data indicate that the depression signs of the stomach observed in UGI when added the position mentioned above are important for screening pancreatic diseases, especially pancreatic carcinoma located at the body.

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Since renal insufficiency is known to be one of the reported causes of hyperamylasemia, the incidence with which this occurs was investigated in patients with chronic renal failure and on chronic maintenance hemodialysis. Moreover, amylase clearance (C_Am) to creatinine clearance (C_Cr) ratios and amylase isoenzyme patterns were determined to evaluate their usefulness in differentiating the hyperamylasemia of such patients from others.
Hyperamylasemia (more than 186 Somogyi units/100ml, which is mean+3 standard deviations of 100 normal persons of 16 to 50 years old) was observed in 50% of the 26 patients with chronic renal failure and 86% of the 84 patients under hemodialysis. The highest serum amylase activity in these patients was 476S.U./100ml. Total serum amylase activity was inversely related to C_Cr?
Although it is generally accepted that renal insufficiency results in an elevated serum amylase level, the markedly reduced amylase clearance of these patients was not reflected by a proportional increase in the serum amylase level, because some patients with chronic renal insufficiency had the normal serum amylase activities. These results may suggest the existence of some extrarenal mechanisms to remove amylase from the serum or the reduction of amylase entering the serum in renal insufficiency.
Amylase clearance to creatinine clearance ratios of patients on hemodialysis and patients with chronic renal failure (5ml/min<C_Cr<70ml/min) was not significantly different from those normal subjects (2.9±0.4%), since amylase clearance was reduced in proportion to creatinine clearance in these patients. Unlike in those patients, the ratio C_Am/C_Cr was significantly increased (9.8±0.9%) in patients with severe impaired renal function (C_Cr less than 5ml/min). These observations indicate that C_Am/C_Cr ratios are of no value for diagnosing acute pancreatitis in patients with severe renal failure, as they elevate in the absence of any clinical signs and symtoms of pancreatitis.
However, analysis of amylase isoenzyme revealed the normal isoamylase pattern in most patients with renal insufficiency, even in those with elevated C_Am/C_Cr ratios. The ratios of the salivary to the pancreatic type isoamylase were similar in both the control and the patients with chronic renal failure. Normal isoamylase pattern probably excludes the diagnosis of pancreatitis in these patients.

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In this study, we developed a reliable radioimmunoassay (RIA) method for Ascaris specific protein (ASP) and measured the serum levels in control subjects (average; 5.94±5.94ng/ml) and in patients with Ascaris and a variety of gastro-intestinal diseases. In all Ascaris carriers, very high concentration of ASP (average; 151.4ng/ml) was observed. 12 out of 38 patients with ulcerative colitis showed significantly high serum levels of ASP. The high titer of ASP and the presence of antibody to ASP, previously described, may suggest the close relationship between ASP and ulcerative colitis.
RIA for ASP, also provides simple method for screening the patients with Ascaris and hence may open the new field in parasitology.

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