Even less is known about the role of gastrin, the most potent stimulator of gastric acid secretion, in the pathogenesis of peptic ulcer disease. The present study was undertaken to determine arginine-stimulated gastrin release in patients with peptic ulcer.
The results obtained herein were as follows :
1. The mean fasting serum gastrin concentrations for the patients with gastric ulcer and duodenal ulcer did not differ from that of normal subjects.
2. Intravenous drip infusion of L-arginine (0.5g/kg, 30min) to normal subjects caused a significant rise in serum gastrin levels to approximately 130% of the baseline at 10min.
3. The peak values of serum gastrin, insulin, growth hormone and glucagon following arginine infusion were achieved at 10, 30, 45 and 30min. respectively.
4. The mean basal (BAO) and maximum gastric acid secretion (MAO) were greater in duodenal ulcer patients than in gastric ulcer patients. However, those of gastric ulcer patients were less than those of control subjects, although no significant differences between two groups were obtained.
5. Arginine-induced gastrin release was significantly greater in duodenal ulcer patients than in gastric ulcer patients. There was no difference between gastric ulcer patients and normal subjects.
6. According to the arginine-induced gastrin release, gastric ulcer patients were divided into 3groups : three types of high, normal and low gastrin response. High gastrin response group appeared to be related to the increased mucosal atrophy in the stomach, low gastric acid secretion and non-relapse cases of ulceration.
7. In duodenal ulcer patients, gastrin response to arginine was neither associated with increased mucosal atrophy nor diminished gastric acid secretion.
Thus, we have demonstrated that intravenous drip infusion of arginine is an effective stimulus for the release of gastrin. The observations described in this report have failed to support the concept that gastrin stasis is the cause of gastric ulcer. However, the increased susceptibility of gastrin release to arginine in duodenal ulcer patients suggests the potential importance of gastrin in the hypersecretory state that frequently characterizes duodenal ulcer disease.

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Spatial differences in the age-adjusted mortality rates (1971-74) from non-infectious chronic diseases were studied in Gunma prefecture by 12 health center jurisdictions (abridged as H.C. in following sentences). The population from 1970 national census was used for these calculations, and direct method was used for these standardization, with the total Gunma prefecture population (by sex) from the census as the standard population. Statistically significant high or low mortality rates were observed as follows :
1) All causes of death
Male : high in Shibukawa, Annaka and Tatebayashi H.C., and low in Maebashi H.C. Female : high in Ota and Tatebayashi H.C., and low in Maebashi and Nakanojo H.C.
2) All malignant neoplasms (B19)
Male : high in Annaka H.C., and low in Nakanojo H.C.
Female : high in Kiryu and Tatebayashi H.C., and low in Annaka and Nakanojo H.C.
3) Malignant neoplasm of Stomach (B19b)
Male : high in Annaka H.C., and low in Nakanojo H.C.
Female : high in Kiryu H.C., and low in Maebashi H.C. and Nakanojo H.C.
4) Malignant neoplasms of Liver (B19c)
Male : no jurisdiction has significantly different rate.
Female : high in Tatebayashi H.C.
5) Malignant Neoplasms of trachea, bronchus and lung (B19g)
No jurisdiction has significantly different rate.
6) Malignant neoplasms of uterus
Low in Shibukawa H.C.
7) Ischemic heart diseases (B28)
Male : high in Takasaki H.C., and low in Tomioka H.C.
Female : high in Kiryu H.C., and low in Isesaki and Nakanojo H.C.
8) Cerebrovascular diseases (B30)
Male : high in Shibukawa and Tatebayashi H.C., and low in Maebashi H.C.
Female : high in Takasaki and Shibukawa H.C., and low in Fujioka and Nakanojo H.C.
Summarizing these results, high mortality rates from all causes of death were effected by high rate from cerebrovascular diseases in Shibukawa and Tatebayashi H.C. male, and by high rate from malignant neoplasms in Annaka H.C. male and Tatebayashi H.C. female. And in Maebashi and Nakanojo H.C. which have low rates from all causes of death, rates from both cerebrovascular diseases and malignant neoplasms were low.

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膠原病, とくにリウマチ熱および全身性エリテマトーデスに心包, 心筋, 心内膜の特徴的な傷害のしばしばみられることは周知の通りであるが, 近年では全身性進行性硬化症PSSにもかなりの頻度で心包, 心筋の傷害を合併することが注目されている.われわれは, (PSS) の心合併症について心電図, 心機能検査の所見を中心に検討する機会を得たのでここに報告する.

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地域医療の前提条件としては各地域の罹病統計の整備があげられる.この見地にたち, 国保診療統計を資料として保険者別の有病状況を把握し, 病因論と医療のあり方に示唆を得ようと試みた.現在の県下国保被保険者数は806,873で全県人口の約1/2を占めるのみで, 得られた所見から直ちに全般を推定することは容易ではない.しかし, 大部分の農村地域住民を包含しているので農村医学的地域医療の立場から有力な情報が得られることが期待されよう.
本県の循環器疾患の動向をさぐる目的で昭和49年度群馬県国保診療統計 (5月分) を資料として, 地域別の受診率 (被保険者1,000人あたりの件数) を計算し, 地域差の解明の一助とした.取上げた病類別疾患は高血圧疾患, 虚血性心疾患, 脳血管疾患が主体であり, 参考として, 消化性潰瘍及びその他の胃及び十二指腸疾患をとった.
その主な所見は次の通りである.
1) 被保険者1,000人あたりの件数即ち受診率を県平均でみると, 高血圧疾患48.29, 虚血性心疾患4.66, 脳血管疾患17.72であった.
2) 県平均より統計学的に有意に高いと判定されるところは※で示したが, これを病類別にみると, 高血圧疾患は県北及び西毛地方に集まり, 虚血性心疾患は前橋, 高崎を中心とする地域と沼田一円に集中がみられる。一方, 脳血管疾患は赤城山及び榛名山を囲む地域に目立ち, また伊勢崎方面に集まっている.
3) 地域分布を順位相関係数からみると, 高血圧疾患と脳血管疾患は有意の負の相関を示し, 虚血性心疾患と脳血管疾患は有意の正の相関を示す.参考として調べた消化性潰瘍と虚血性心疾患とは有意の正の相関を示したことは興味が深い.
4) 以上の所見は国保診療統計によって判断したものであるが, 県全般を推定する資料として地域医療という角度で活用の余地が少くないと考える.

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