FOLLOW UP STUDY ON MAGNIFYING OBSERVATION OF MARGINAL REGENERATIVE EPITHELIUM OF GASTRIC ULCER BY MEANS OF NEWLY DEVICED GTSROAFIBERSCOPE, TYPE GIE-HM

Abstract

A comparative investigation was done about the regenerated murosal appearance of intractable (I. U.) as well as tractable (T. U.) gastric ulcers. Using GIF-HM (maximal mag nifying rate : thirty five times), the marginal appearance of 73 gastric ulcers of 39 patients were studied. The gross endoscopic stages of the ulcers were classified into active (AT, A2), healing (HI, H2) and scarring (SI, S2) stages according to the Sakita and Miwa's classification. We could classify the patterns of the marginal appearance into palisade-, nodule-, and spindle-like appearances. We simplified those three patterns to mono component type (MI), mixed type 2 (M2: 2 of three patterns), mixed type 3 (M3: all of three patterns). The T. U. were subdivided to primary and reccurent ulcer groups. Histologically, the nodule-like appearance was found to be riped regenerated tissue and others were relatively unriped. The ulcers which showed the nodule-like appearance at the active stage were I. U. and rec-curent ulcer group. In general, M2 type was observed in the T. U., and began to appear at the active stage of them. M3 type was observed from A2 stage of I.U.. Then, we investivated the course of primary ulcers, they had multiple patterns, but most of them were M2 type. As the course, MI type transformed to M2 and M3 type. Changing the types each other, the ulcers healed to scarring. On the contrary, the mucosal appearance of I. U. had nothing to do with the stage, and M3 type was observed, it was continuously kept to the scarring stage. In case of mucosal appearance changed, I. U. took long time. It is concluded that it is possible to estimate whether ulcer will heal easily or not, in the first magnifying endoscopic examination.