Abstract
On the basis of studies on some 6000 cases of gastric ulcers biopsied in our clinic for past five years incidence of the ulcer, rate of recurrence and its direction (means which site in the neighborhood of initial ulcers is involved in recurrence) were revealed as follows. In attempt to give histological evidences to the endoscopic findings degree of decrease in diameter of the blood vessels and extent of submucosal fibrotic hyperplasia were measured under microscope. Incidence of the ulcer in general, observed by region was high dominantly in the corpus while multiple ulcers were seen more frequently in the antrum than solitary ulcers. Rate of recurrence, studied by region, was highest in the antrum characteristically among young patients. Studies on direction of recurrence in 285 cases revealed that 95% of antral ulcers recurred in the oral side of initial ulcers and 42% of ulcers seen in the angle and lower portion of the corpus showed the same atitude as the above, while of recurrent ulcers 42% appeared in anal side and 28% in oral side of the initial ulcer. In second recurrence the majority of ulcers occured in the same site as the previous ones. This tendency was especially marked in recurrent ulcers which appeared within 6 months. Microscopic measurement of extent of submucosal fibrotic hyperplasia revealed that ulcers site in the corpus were acompanied with the more intensive fibrotic hyperplasia in the oral side than in the anal one. This was especially marked in initial ulcers. In the neighborhood of initial ulcers decrease in diameter of the vessels was more marked in the oral side of ulcers of the antrum, angle and the lower portion of the corpus while more marked in the anal side of ulcers of the middle and upper corpus. In the neighborhood of recurrent ulcers, there were seen no significant difference by region. It is probable from the above-described results that disturbance of blood stream caused by decrease in size of vessels and submucosal fibrotic hyperplasia on regulative factors on recurrence of ulcer and its direction in addition to other unknown mechanisms.
