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In an attempt to investigate the causes of common bile duct dilatation (CBDD), activity of the pancreatic enzymes in bile aspirated from the dilated duct during laparotomy was measured in 24 children with CBDD. The reasoning behind this is the fact that the existence of activated pancreatic enzymes, namely raised activity of all enzymes accompanied by trypsin activation, can be regarded as an acquired result of an anomalous choledochopancreaticoductal junction (ACP-DJ). All of the pancreatic enzymes measured were activated in 14 cases (58.3%) but no evidence of activation of enzymes, such as trypsin or others except for amylase and lipase, was observed in the remaining 10 cases (41.7%), whether an ACPDJ was present or absent. Eight of the 10 patients with no enzyme activation (33.3% of the total) were less than 2 months old. The findings in these eight infants, which included cystic dilation or hypoplasia of the intrahepatic duct, provide strong suggestive evidence of the congenital nature of these cases. These results suggest that at least one third of CBDD cases are congenital and the remaining cases are either acquired or a combination of congenital and acquired, or both.

A compact atomic force microscope that can easily find and position the surface point to be measured has been developed. Tip spring displacement is detected using an optical sensor that detects the focusing error. The objective lens of this sensor is also used to project an optical image of the sample surface onto a CCD image sensor. A micro-step XY stage mechanism has been developed to move a sample over a wide range. When a single cosine waveform voltage is applied to a piezoelectric tube scanner, the quick bending motion causes the sample holder to progress by frictional force. This mechanism can drive the sample holder two-dimensionally in μm-order steps. Using this mechanism, the point to be measured is easily positioned. Subsequently, the sample is moved by the same tube scanner with the usual scanning mode of an atomic force microscope. This atomic force microscope is compact and stable, because no additional XY stage is necessary to position a sample.