THE PATHO-PHYSIOLOGICAL STUDY OF PEPTIC ULCER BASED ON THE GASTRIC END-EXOCRINE FUNCTIONS AND MORPHOLOGICAL CHANGES IN THE PYLORIC GLAND AREA

Abstract

Sixty-two patients with gastric ulcer (GU) and 59 patients with duodenal ulcer (DU) were each divided into two groups according to the values for MAO to histalog stimulation; normosecretor with a MAO below 20 mEq/h and hypersecretor with a MAO above 20 mEq/h. Following investigations were executed on these patients. The gastric acid response to insulin hypoglycemia was determined after an intravenous administration of 10 U of regular insulin. The serum gastrin responses to insulin and meat extract were measured by radioimmunoassay using CIS-gastrin kit. The tissue gastrin concentration in the mucosa of pyloric gland area was also measured by radioimmunoassay. The evidences of gastritis accompanying with GU or DU were observed microscopically. Based on these studies, the differences in clinical and physiological aspects between patients with GU and DU were definitely analysed.
Functioning parietal cell mass (FPCM), functioning G-cell mass (FGCM) and vagal capacity were all increased in hypersecretor of DU. FGCM and vagal capacity were also increased in normosecretor of DU, but FPCM was decreased in number in this group. The increases of FPCM and vagal capacity were observed even in hypersecretor of GU, whereas FGCM showed only a slight increase, comparing to that of normosecretor of GU. In normosecretor of GU, FPCM was decreased, and vagal capacity was significantly limited. From these results, it was noted that a part of patients with GU has similar clinical features with patients of DU. The incidence in all the patients with GU was about 30 per cent. Accordingly, the treatment for hypersecretor of GU should be considered in a different manner from that for normosecretor of GU.