抄録
By clinical observations on patiens after gastrectomy and experimental studies on animals for years, the pathogenic mechanism of reflux esophagitis was made clear and measures to prevent it was devised.
(1) Comparative anatomical studies on several kinds of mammarian animals showed that there were respectively characteristic antireflux mechanisms at cardia.
In man, the muscular fibres so arranged as to constrict the inferior end of the esophagus and the diaphragmatic muscles were anatomically recognized as two leading factors of antireflux and the significance of these factros was as certained by the funcional investigations on dogs.
(2) Determination of isoelectric points of coating epithelial cells in experiments on dogs proved the local specific character of the esophagus that its mucous membrane was the least resistant to duodenal juice or hydrochloric acid in the upper alimental tract. And esophagitis was experimentally produced by contacting a 2.5% solution of bile acid, duodenal juice with bile acid eliminated, or 0.3% hydrochloric acid with esophageal mucons membrane.
(3) As the objective records of the changes were important for clinical investigations on esophagitis, the direct esophagoscope for color photography devised by, Matsumoto was introduced and various pictures of esophagitis photographed with this instrument were displayed.
(4) Incidence of esophagitis after gastrectomy amounted to 53%, which would be remarkably reduced after 4-5 years.
And reflux esophagitis was well prevented and cured by application of a bed inclining 10-15 degrees to hold up the upper part of the body.
(5) Clinical symptoms and roentgenographic findings of reflux esophagitis were detailed.
(6) The method of operation to avoid postoperative reflux esophagitis was mentioned.
