Ratの胃粘膜再生に関する実験的研究 胃血管結紮による胃粘膜の変性および再生の経時的変化に関する病理組織学的研究
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An attempt has been made to the analysis of the damage of the gastric mucosa and its repair by regeneration in lesions of chronic gastritis and gastric ulcer. The animals used were Wistar rats. Three main arteries of the stomach, together with veins, were cut off and the neighboring organs and tissues were also seperated as thoroughly as possible. All rats were necropsied from 30 minutes to 55 days postoperatively. The acidity of the gastric juice at the time of sacrifice was determined by histamine test. The experimental results and conclusions were as follows.<BR>1) The damage of the gastric mucosa is mainly due to arterial ischemia, but venous factors, such as congestion, edema and so on, are partly concerned.<BR>2) The damage of the gastric mucosa occurs constantly at the f undic area, which is considered to be most differentiated. The damage begins symmetrically from the greater curvature gradually. At the lesser curvature, the f undic area adjacent to the fold-like ridge and the pyloric area near the duodenum are fairly well preserved. The areas are considered to be the site of the later regeneration of the mucosa. As to the extent of the damage of the mucosa at the pyloric area and the ampulla (Vormagen), there is considerable variation and no clear cut rules are present. This may be partly due to the variety of the vasculature and the manual skill of the ligation.<BR>3) Histologically the damage begins with degeneration and breakdown of parenchymatous cells of fundic glands followed by necrotic foci of varing depth and breadth. The spreading of necrotic area becomes most prominent on the 3rd or 4th day after operation. At the base of lesions leukocytic infiltration is marked and lesions are demarcated. Crusted necrotic foci fall off and denuded area (ulcer) is formed. The base of the ulcer is formed by inflammatory granulation tissue. As the result of the perforation of the entire gastric walls due to necrotic breakdown, the formation of the granulation tissue of foreign body type is also present till about the 20th day. The adhesion of the neighboring tissues and organs also takes place.<BR>4) About the 5th day the surface of the ulcer is gradually cleaned up, the regeneration of glandular epithelia from the remaining gastric mucosa occurs and the repair takes place. Both epithelial regeneration from the fundic and pyloric area are of f oveola gastricae type and resemble pyloric gland (uncomplete regeneration of the fundic area) .<BR>5) The regeneration of the gastric mucosa becomes prominent from the 7th or 8th day and the greater part of the surface of the ulcer is covered with newly formed epithelia on about the 15th day. About the 20th day the area of uncomplete regeneration becomes narrower and the fundic area spreads and this indicates the progress of the repair of the fundic parenchyma.<BR>6) The regeneration of the fundic parenchyma completes on the 30th day. But the gastric juice proves to be acid-free. The discrepancy between the nummerical recovery of parietal cells and the functional recovery of gastric acid secretion exists, but this discrepancy disappears on the 40th day, as histamine test is concerned.<BR>7) Chief cells regenerate in the latest stage and they are less in number. Intraplasmic thionine granules of regenerated chief cells are decreased in number. Whether or not the regeneration of chief cells is resulted from the differentiation from mucoid cells cannot be clarified by this experiment.
- 学校法人 昭和大学・昭和医学会の論文