Abstract
Endoscopical and histopathological study had been done to 1556 cases of endoscopically proved duodenal bulbar ulcer. 233 cases had been observed to have "Shimofuri" lesion which reveals pepper-and-salt appearance of fundamentally mucosal hyperemia and tiny whitish mucus coating (to be abbreviated to Shimof uri). The result were : 1) Endoscopic manifestations of Shimofuri was characterized by tiny whitish mucus coating with mucosal hyperemia. 2) The distribution chart of age group on duodenal ulcer cases in which Shimofuri was observed showed the highest in twenties (30.9%). 3) Shimof uri was always coexisted with duodenal ulcer and was observed on 15% of bulbar ulcer cases. 4) 91.7% of Shimofuri was found in the vicinity of an ulcer and 8.3% on the remote site of an ulcer. 5) Histopathological study of Shimofuri showed non-specific inflammatory reaction on mucosa accompanied by erosive lesion. Clinical study was also done on our follow-up cases of 108 Shimofuri in 277 bulbar ulcer (follow-up duration from 3 months to 9 years and 5 months) that showed: 1) Shimofuri was observed in comparatively incipient course of duodenal ulcer and then one disappeared shortly where another repeated frequent appearances. The form of its appearance was in various ways. 2) The healing rate of duodenal ulcer within 3 months and the recurrent rate of duodenal ulcer within 1 year made no difference between the group of Shimofuri cases and that of non-Shimofuri cases. But the duration of sickness on Shimofuri cases tended to extend over a long time. 3) 12 long term follow-up cases more than 4 years were studied only to gain an interesting result, that is, the appearance of Shimofuri decreased after 4 years' duration and in 8 cases Shimof uri did not appear for more than 4 years since the last Shimof uri had been observed. 4) It is considerable that the function, especially the relation with the gastric secretory function, should be made much of to trace the appearance of Shimofuri to its origin here-after.
