When the five various kinds of stress, namely light, sound, electric stimulus, confinement, and fasting, are applied for twentyfour (24) hours continually, some canspicuous morphological changs are observed in the stomach mucous membranes, adrenal glands, thymus glands and hypophysis of the rat. At the same remarkable decrease in body weight, eosinopenia and rela tive lymphopenia in the blood were discernible.
When the similar kinds of stress were applied for three (3) hours per day for four (4) consecutive days, about the same results were obtained. Using these stimulases as emotional stresses, I have observed how they influence on the healing process of the artificial gastic ulcer of the rat.
Thus I have obtained the following observations.
(1) Out of sixty-two (62) cases of stress group death took place in twenty-one (21) cases in four (4) days to four (4) weeks after the operation. In most cases where death took place within five (5) days peritonitis caused by ulcer perforations was discernible. Histologically the granulation formation of the bottom of the ulcer was greatly inhibited. In the cases where death took place later than the tenth day much hemorrhage in the stomach must have been the cause of death. In these cases there-epithelialisation on the bottom of the ulcer was remarkably delayed.
(2) In the forty-four (44) cases of control group no cases of death like these wre not discernible.
(3) The tardiness in the healing process to be summarized in the inhibition of the growth of granulation tissue and the delay of the epithelialisation was discernible in the survival group, if compared with the control group. Of course, it is not so conspicuous as in the death group.
(4) I further compared the weight and the histologic changes of adrenals and thynus glands through the healing process with those of the control group, and I seem that this tendency of the tardiness of healing and the changes in perforations and hemorrhage have a close relation to the functions of this emotional stress through pituitary-adrenal axis.
(5) I, moreover, compared the gastric juice pH of the control group with that of the stress group, but any momentous alteration was not recognizable.

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In order to give a correct diagnosis on the stomach by gastrocamera, author studied in this series, careful analysis on the gastrocamera pictures and their pathohistological findings made of corresponding areas in the same resected stomach were contrasted with each others.
Meterial: Total loo cases out of which 14 cases of primary chronic gastritis, 36 ases gastric carcinoma, 34 cases of gastric ulcer, 14 cases of duodenal ulcer and 2 cases of gastric polyposis.
A.Chronic gastritis
2 lo lesions were analized in 14 cases of primary chronic gastritis and 67 cases of accompanying chronic gastritis.
1.The gastrocamera pictures of chronic gastritis was classified into 3 foundamental types.
I type: The characteristic findings are pathological mucus and edema on the mucous membrane.II type: The folds are appearently small, rather diminished or disappeared, therefor the surface of the mucus membrane looks flattened or rough.Another chief finding is alarge granular formation on the mucosa. III type: The most of the gastric folds are more or less enlarged and irregularly thickened.
Then large unheaval granular formation looks on the surface of the folds and between its.
2.Above classification due to gastrocamera was compared with their pathological changes, 72% of type I is superficial gastritis, 91% of type II is atrophic or atrophic hyperplastic gastritis, 61.5% of type III is superficial gastritis and 23% of type III is hypertrophic gastritis.
3.Similar figure to gastrocamera not always point out same pathohistological finding, especially superficial gastritis.Therefor, it is necessary to put careful analysis on gastrocamera pictures of chronic gastritis.Although one can easily diagnose chronic atrophic gastritis to gastocamera, it is difficult to differentiate whether hyperplastic change or intestinal metaplasia exists or not.
B.Gartric ulcer Corelation between gastrocamera pictur and trend of gastric ulcer-healing or aggravating-was studied in 30 cases incheding 36 lesions.
1.Thick and dirty coated and mucus attached ulcerative surface is usually found bymeans of gastrocamera on the aggravating ulcer.In such cases as the ulcer surface iscompletely reconstructed but hemorrhagic exsudation or LEISTENSPITZENEROSION are present to histological examination, differenciation of the healed ulcer from a small ulcer by gastrocamera is very difficult because of existing the thick white coat and mucus.
2.No closed relation between trend of ulcer and finding about the edge or the surrounding mucus surface of ulcer.
C.Duodenal ulcer
Gastrocamera shows apparent deformities or pyloric insufficiencies in 14 cases accompanied by ulcer produced near pylorus or ulcer with strong fibrosis.So gastrocamera is valuable for a complimentary diagnostic method in duodenal ulcer.
D.Gastric cancer
1.According to my gastrocamera pictures the following 3 types are classified, as localized type, infiltrative type and intermediate type.
2.It can not be conclusive that there is a corelation among above my classification, Borrmann's and pathohistological classification on gastric cancer.However it seems that each the localized type to gastrocamera and to Borrmann's are corresponding more or less, and shows rather benign type pathohistologically.Also the same result is obtained in my studies on the infiltra tive type.
3.Gastrocamera is useful to differenciate malignancy from benign as well as to determine chronic ulcer which is already changed into malignant or not.
As far as serious consideration is placed on analysis of gastrocamera pictures, gastrocamera test is a simple and an excellent Method and combined evaluation with other tests is choice of method for diagnosis of gastric disorders.

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The changes of the chemical composition of liver tissue, obtained by needle biopsy in health and diseases, were estimated by ultra-micromethod.Furthermore, experimental studies were made on the rat liver feeded by dried cells of Penicillium islandicum Sopp and toxic rice containing the fungi for comparing with the clinical studies.
The results obtained were as follows.
1) As the method of chemical determination of collagen, the condition of Gordon Fel's method determining hydroxyproline was investigated and it was found that this method was quite satisfactory.
2) The ultra-micromethod using few milligrame of liver tissue obtained by biopsy was observed to be significant for the analysis of chemical composition.
3) In acute liver injury, the changes of enzyme activities were remarkably noted clinically and experimentally.However, the chemical composition did not show any change except the decrease of liver glycogen.
4) In cases of chronic liver diseases any chemical change was not observed.In rat liver, the amount of collagen increased when fibrosis was found histologically.
5) In experimental cirrhotic livers, fibrosis and increase of collagen were remarkable. The content of collagen increased from 5 to 7 folds compared with the normal level. The increase of hexosamine was noted in fibrous part of liver.
6) It was concluded that the experimental liver cirrhosis by P.ial.Sopp was a postnecrotic form, not developed via fatty liver, since the fatty infiltration was not found chemically and histologically these animals.
7) The decreases of liver protein, serum protein and serum albumin were observed in experimental liver cirrhosis.The serum γ-globulin increased and the content of hemoglobin decreased.8) The increase of collagen of various liver diseases was chemically estimated.The highest level was obesrved in cholangioma and lowest was in Banti's syndrome.The increase of collagen was moderate in Wilson's disease, Pick's disease, Laennec's liver cirrhosis, acute yellow liver atrophy, biliary liver cirrhosis and hepatoma.

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It is known that liver function has a many sided phase.
Hence there are many means of liver function test. The author has compared the obtained results by the method of G-reaction, which was devised by K. Shozushima, with those of the other methods of reaction for liver function test as well as having traced the relation between G-reaction and serum protein picture.
The results were revealed as follows: In the case of liver disease G-reaction revealed the higher positive degree than those of Thymol turbidity test (TTT), Serum iodic acid value, Takata's test, Gros' test, Sublimate test, Cobalt reaction, Zinc sulfate test, and Ehrlich's urobilinogen test, with the exception of Bromsulphalein test. In the case of hepatic infectiosa it revealed the positive rate of 90% and its responding degree recovered gradually in accordace with the cure of the symptoms. In the case of hepatic cirrhosis the positive rate was 100% and also in that of hepatic carcinoma it was 86.7%. In the case of nephropa thy the higher positive rate was seen in nephrosis and in chronic nephritis accompanied with nephrosis. Observing the corresponding rate between the results of G-reaction and those of the other kind methods, that is, 67.5% between it and Cobalt reaction, 65% between it and Sublimate test, 64.4% between it and Serum iodic acid value, 63.5% between it and T. T. T., 58.3% between it and Takata's test, 57.1% between it and Zinc sulfate test, and 54.5% between it and Gros' reaction.
G-reaction had a correlationship respectively with those of Sublimate test, Serum iodic acid value, Gros' reaction, T. T. T., and icteric index. However, no correlation was recognized with those of Bromsulphalein test, Zinc sulfate test, Cobalt reaction, and Takata's test. From the observations of correlation between G-reaction and serum protein picture, though with no relation to serum total protein it had relation with Alumin and β + γ Globulin.
From the present experimental studies, it is considered that the method of G-reaction for liver function test is so simple in its operation and so keen in its reaction that it is available to recommend as a means for clinical diagnosis.

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1) Four cases of the multiple cancer were found in the forty specimen of oesophagus and stomach which were resected in the Surgical Department of Showa Medicel School and Tokyo University between November 1953 to December 1957. Among those cases the cancers of the stomach were based on the polyp or polypic cancer of the stomach.
2) One case was discovered which had rectal cancer and stomach polyp at the sametimes.
3) Among the 44 specimens which were resected whole stomach, abnormal hyperplasia of the oesophagus mucosa was found in 2 cases.
4) The stimulation, which is seemed to be the cause of the oesophagus or intestinal cancer, is also seemed to the cause of the stomach polyp.
5) From the statistical study of the multiple cancer in Japan the frequencey of the stomach cancer seemed to be lesser then that of general statistics. And among them, there were 32% of Borrmaii. I Type and polys cancer.
6) From this study a local stimulation is seemed to be necessary for the development of the stomach cancer, contraly to this, the stimulation which is the cause of oesophagus or intestinal cancer seems to be the cause of abnormal hyperplasia of the stomach mucose.
7) Multiple cancer developed separately in other place at the same time by the same cause of the cancer.

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650 cases of various liver diseases were studied electrophoretically and ultracentrifugally salong the clinical courses.
Each liver disease has its proper electrophoretic pattern of serum protein but not all cases did show the typical proper pattern. Therefore, it was necessary to observe the protein pattern repeatedly along the clinical course for diagnosis. Especially, in hepatitis, and liver cirrhosis, the alteration of serum protein pattern indicates the alteration of its clinical progress, and then it was valuable to determine the prognosis of disease. In liver cirrhosis, gradual elevation of gamma globulin percentage in serum protein foreboded a poor prognosis. Conversely, decreasing gamma globulin with a treatment was a sign of good prognosis.
On the end stadium of liver cancer, in spite of its nature, primary or secondary, high level of gamma globulin was observed. In such cases, percentage of gamma globulin fraction to total globulin but total protein was more useful to analyse the clinical situation.
In obstructive jaundice, elevated value of gamma-1 fraction was often observed sharply during the course of alteration of serum protein A-component by ultracentrifuge was correspondent to alubumin fraction by electropho, resis and G-component to gamma globulin fraction. However, in cases of paraproteina emia of alpha- or beta-myeloma, G-component contained these alpha- or beta-globulin fractions. These alpha- or beta-globulin fractions in paraproteitaemia showed different attitude in the Zinc-Sulfate turbidity test with gamma globulin fraction of normal and, gamma-myeloma, in spite of same G-component in ultracentrifuge. G-component value was closely correlated to Zinc-Sulfate turbidity test, and slightly to Thymol turbidity test. A-component value correlated slightly to serum cholinesterase value. BSP test had a slight correlation to G-component in liver cirrhosis. Alkaline phosphatase has no correlation to each component. In many cases which showed intensive jaundice, Xcomponent value was elevated.
On the ultracentrifugal pattern of other pathological sera, qualitative change of pattern. was observed in following diseases; splitting of A-component in several hepatoma and cholangioma, and a small peak appearance preceding G-component in some myeloma.

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Studies were made about enzymatic activities both in serum and hepatic tissue of patients with liver disease and of animals with experimental liver injury. The enzymes.determined were glutamic oxalacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), glucose-6-phosphatase (G6Pase), aldolase (Ald.), alkaline phosphatase (Alk. ph.) and arginase (Arg.).
The results obtained were summarized as follows:
1) When enzymatic activities were determined on biopsied hepatic tissue, in which only few mg. of wet weight could be obtained, the ultra-micro method was devised and employed. There was no difference between the enzymatic activities measured by the ultra-micro method and these by macro method.
2) All of serum enzymatic activities of patients with liver disease showed a tendency of increasing. In patients with hepatic parenchymal damage, the enzymatic activities, especially GOT and GPT, elevated remarkably. In patients with liver cirrhosis, serum GPT activities remained slightly elevated. Serum G6P ase activities increased much often in almost all kind of liver disease.
3) Liver enzymatic activities had a tendency of increasing. In patients with hepatitis and obstructive jaundice, GPT and G6P ase activities in some cases decreased distinctly. In patients with liver cirrhosis, GPT activities also decreased. The activities of Alk. ph. tended to increase, especially in patients with obstructive jaundice and liver cirrhosis.
4) In dogs injured by carbon tetrachloride, it was observed that increased serum enzymatic activities corresponded to decreased hepatic enzymatic activities. Therefore it was interpreted that the elevation of serum enzymatic activities resulted from releasing of enzymes from damaged liver cells into blood stream. Serum GOT and GPT activities changed most closely related to liver histological findings. Other serum enzymes except GOT and GPT showed delayed normalization of increased activities. Serum G6P ase activities elevated remarkably already 6 hours after carbon tetrachloride administration. Alk. ph. activities alone increased slowly both in serum and liver, so that it was assumed that disorder in excreting function of liver resulted in elevating of serum Alk. ph. activities.
5) GPT activity of cirrhotic liver of rats, experimentally induced by feeding the diet containing Penicillium Islandicum Sopp, decreased distinctly. However GOT activity in the same rat liver did show slight decrease. These facts indicated that the reduction of enzyme production of GPT occured in liver cells, and would explain the not so high increase of serum GPT activity in these rat.
It was concluded in these studies that determination of serum enzymatic activities, especially GOT and GPT, had great clinical significance in diagnosis and prognosis of liver disease, especially of hepatic parenchymal disorder.

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Biological significance of sulfur-containing amino acids in the body has gradually become recognized in recent years but majority of studies made on them has been fundamental and examinations as to their relationship to clinical pathology have been left for future work.
As a part of studies on the mechanism of ethionine damage, metabolism of sulfurcontaining amino acids chiefly in the liver and the pancreas was examined, using (S³⁵) methionine as a tracer.
Summarized results thereby obtained were as follows:
1)(S³⁵) Methionine was administered intraperitoneally to normal mice and the amout of the amino acid consumed by each organ was examined by measuring radioactivity.There was a fairly great diflerence between the organs. The amount of the labeled amino acid was generally greater in the organs with strong metabolic activity, such as the liver, pancreas, kidneys, and intestines, and extremely small in the muscles and the skin.
2) Methionine is metabolized in the body down to inorganic sulfate and excreted but ethionine is not metabolized and the majority is excreted into the urine. Chromatography of organ proteins has shown that incorporation of ethionine into organ proteins is detected even 3 days after administration, when detection in the non-protein portion becomes difficult. The incorporation is especially marked in the liver and pancreas and the fact agrees with the high incidence of damage in these two organs.
3) Experiments both in vivo and in vitro have shown that incorporation of (S³⁵) methionine into the liver and pancreas proteins is suppressed by ethionine.
4) Perfusion of rat liver with a solution containing (S³⁵) methionine and measurement of radioactivity of the proteins in the perfusion fluid showed that incorporation of (S³⁵) methionine at the time of plasma protein synthesis in the liver is also interfered by ethionine.
5) The course of metabolism of (S
35) methionine in the hepatic and pancreatic tissues was examined by radiochromatography of the tissue hydrolyzate. No detailed results were revealed on individual intermediate metabolites but metabolism of (S³⁵) methionine seemed to be interfered by ethionine.
6) The same experiments were carried out on animals damaged by carbon tetrachloride and chloroform, and it was learned that there was no suppression of (S⁵³) methionine incorporation into the liver proteins. Metabolic decomposition of (S³⁵) methionine in the tissue also did not show any definite tendency of suppression as in the case of ethionine damage.

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Circulating lipid fractions inclusive of nonesterified fatty acids (NEFA) were determined in 75 diabetic patients and their changes by therapy were observed. The following results were obtaincd.
1. In about 2/3 cases of diabetics, levels of circulating lipid fractions before treatment are normal, and in 1/3 cases levels of total cholesterol (TC), total phospholipid (TP), total lipids (TL) are elevated.
2. In cases with long duralion (>20 yrs), the value of TC, estercholesterol (EC), TP, total fatty acids (TFA), TL are elevated.
3. In cases with high fasting blood sugar before treatmeut, TC, EC, free cholesterol (FC) and NEFA are elevated, and NEFA are remarkably elevated in cases with ketosis.
4. In cases with much urine sugar (>100g), levels of TC, EC, FC, TP, NEFA are elevated.
5. The close correlation is not found between levels of lipid fractions and Broca-Index of patients, NEFA are increased in obese patients.
6. In diabetes with vascular complications, the other lipid fractions are elevated than in cases without vascular complications, but TP levels are lower and TP/TC is decreased.
7. In younger diabetic patients (<29 yrs), lipid fractions inclusive of NEFA are more elevated than in older patients.
8. After treatment with diet contol, insulin, sulfanylurea, phenethyldiguanide, these abnormalities in levels of circulating lipids are improved and the insulin therapy is the most effective.
9. Observalion of plasma nonesterified fatty acids may be a criterion for control of diabetes mellitus and carbohydrate metabolism disorders.

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Three cases of pseudomyxoma peritonei (the term “pseudomyxoma peritonei” will be abbreviated to “P. P.” in this paper), 1 case of gelatinous abdomen due the rupture of an ovarian cyst, and 6 cases of mucocele appendicis (the term “mucocele appendicis” will be referred to as “mucocele” ) were treated recently by the auther with interest. Furthermore, the review of the literature, statistical observation and animal experiment was made about these diseases.

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