Abstract
The origin of the gastric epithelium in the duodenal mucosa were studied clinically and histologically.Material and Methods: Biochemical, histological analysis and autoradographic studies of gastric metaplasia in the duodenal bulb were performed using biopsy specimen taken from 200 cases.Results; 1) The gastric epithelialial metaplasia in the duodenal bulb were observed endoscopically in 174 among 200 cases (about 87%); about 50% of them showed ulcerous changes. Hepatocholangeal disorders were associated frequently. 2) Gastric juice analysis was found to be hyperaciditic in 40 among 53 cases with gastric metaplasia. 3) most of the gastric epithelial metaplasia in the duodenum showed strongly reddish villous-like structure and appeared around ulcer, or around pylorus. 4) The gastric epithelial metaplasia in the duodenum occurred frequently in the healing process of the duodenal ulcer. 5) Histologically the cells were quite same to the original gastric epithelialcells; They consisted almost of the epithelium, however parietal cells were also observed partially. In the pyloric area aberration was seen in 5 cases. 6) Jn 17 of 25 resected cases with gastric epithelial metaplasia, the ulcer were UL III or IV. 7) In the tests with 3H-tymidine, 35SO4, and 3H-glucoose autoradigraphy it was confirmed that the gastric epithelial metaplasia occurred in generative zone. In the mucin metabolism test with 35SO4 and 3H-glucose, the cells of gastric epithelial metaplasia showe d the characteristics of regenerated cells of intestinal mucosa. 8) From these observations it was suggested that the gastric epithelial metaplasia in the duodenum would have some relation with mucous barrier as well as well as Brunners glands.
