Takeo Yamagishi

G-cell population in antral mucosa of the dog

The gastrin-cell (G-cell) population in the pyloric antrum of 8 dogs was studied quantitatively by immunofluorescence. The G-cell population was dense in the pyloric antrum and very few cells were seen in the antrocorporal junction. The estimated total number of G cells was (1.66±0.12)×107 in the pyloric antrum and the greatest number of G cells per unit mucosal surface area was along the greater curvature of the pyloric antrum. Except along the greater curvature, G cells per unit mucosal volume were significantly greater in number (P<0.05) in the proximal antrum adjacent to the antrocorporal junction than in any other regions distal to it. Differences in mucosal thickness were considered as a causative factor for these differences.

A histopathological study on pyloric ulcer.

SummaryAfter the pyloric ulcer was defined as a peptic ulcer occurring at the pylorus or having its centre in the prepyloric region within 2 cm from the pylorus, its histopathological features were studied on 94 pyloric ulcers in 88 surgically resected stomachs. 72.3 per cent of these ulcers were less than 1.0 cm in diameter. The incidences of Ul-II, III and IV ulcers were almost equal, and the majority of Ul-II and Ul-III ulcers were found in scarring stage in the specimens. These pyloric ulcers were classified into three types according to whether the centre of ulcer is situated above (Type-1), on (Type-2) or below (Type-3) the pylorus. Type-1 ulcers were the most frequent, their incidence being 70.2 per cent. On histologic examination, it was observed that duodenal gland area extended over the pyloric antrum in 90 per cent of the specimens. Contrary to the mucosal rule of Oi for the genesis of peptic ulcer, pyloric ulcers were located in pyloric gland area in 30.9 per cent and on the glandular boundary in 57.4 per cent. Only in 11.7 per cent, the ulcer developed in duodenal gland area. In 68.2 per cent, pyloric ulcer was associated with other gastric or duodenal ulcers. The majority of these coexisting gastric ulcers occurred in the pyloric gland area adjacent to the antrofundic border, and all the duodenal ulcers in the proximal duodenum. Moderate or severe atrophic changes in gastric antral mucosa were found in a large number of the specimens with coexisting gastric ulcer, whereas the changes were less pronounced in those with pyloric ulcer alone.

Neurohumoral inhibitory mechanism initiated by antral distension.

This study examines the effect of graded antral distension with acid (0.1 M HCl) or alkali (0.1 M NaHCO3) on pentagastrinstimulated acid secretion in two groups of dogs. Group A consisted of six dogs provided with innervated antral pouch. In these dogs, the vagal branches to the fundus, as well as the extragastric vagal divisions (hepatic and celiac), were preserved. All of these animals had a gastric fistula in the main stomach, and in two a denervated fundic pouch or Heidenhain pouch was constructed in addition. Group B consisted of four dogs with an innervated antral pouch and gastric fistula. In this latter group, however, parietal cell vagotomy as well as extragastric vagotomy (division of the hepatic and celiac branches) was performed so that the only vagal communication was between the antrum and the CNS. Antral distension with acid caused significant inhibition of pentagastrin-stimulated acid secretion from both the gastric fistula and the Heidenhain pouch in Group A dogs. Antral acidification without distension did not inhibit. Alkaline antral distension in this group caused much less inhibition of acid secretion, but did cause significant increase in circulating immunoreactive gastrin. In Group B dogs, antral distension with neither acid nor alkali caused inhibition of pentagastrin-stimulated acid secretion, indicating that intact vagal supply to the oxyntic mucosa and/or to the extragastric abdominal organs is necessary for the inhibitory mechanism to operate. The results of this study suggest that: a) antral acidification per se does not inhibit pentagastrin-stimulated acid secretion; and b) antral distension with acid, and to a lesser extent with alkali, is inhibitory only if vagal innervation to the fundus and other abdominal viscera is preserved. The observations are compatible with the hypothesis that antral distension activates a neurohumoral inhibitory mechanism releasing the inhibitor reflexly from sites other than the antrum or CNS.

Inhibition of gastric secretion by intraduodenal hypertonic glucose in patients with duodenal ulcer.

SummaryIntraduodenal instillation of hypertonic glucose significantly inhibited tetragastrin-induced gastric acid and pepsin outputs in man. The secretory volume of gastric juice was markedly decreased, whereas, acid concentration remained unchanged. Pepsin concentration, on the contrary, was reduced significantly. The degree of inhibition of pepsin output, therefore, was greater than that of acid output. No significant difference in the extent of inhibition of acid or pepsin output was observed between control subjects and patients with duodenal ulcer.

Blood serotonin level and hemodynamic changes induced by instillation of hypertonic solutions into upper gastrointestinal tract

T h e presen t invest igat ion reports polypold lesions of the colon a n d the r ec tum observed in the latest 500 consecut ive au topsy eases pe r fo rmed in this hospital . T h e p r ima ry interests are focused on the relat ion of the a d c n o m a t o u s polyps to their m a l i g n a n t al terat ion. T h e mater ia l consists of the cases wi th ages be tween 57 a n d 97 years (average 78.9 years). T h e conclusions are as follows: 1) T h e incidence of the polyps in the colon and the r ec tum was abou t 30% in the aged. 2) A d e n o m a t o u s polyps con ta in ing ca rc inoma were seen in abou t 10% of the polyps wi th the maxi m u m d iame te r over 1 cm. M a l i g n a n t a l tera t ion was suspected histologically in bodl of two polyps wi th m a x i m u m d iamete r over 2 cm. 3) T h e most of the m a l i g n a n t al terat ions were seen in the mul t ip le polyps. 4) T h e polyps were scat tered bu t were more often found in the r ight ha l f of the colon. T h e pa t t e rn of d is t r ibut ion of the polyps did no t cor respond to tha t of the cancer . Th i s was par t icu lar ly ev ident in the rec tum. 5) T h e m a l i g n a n t a l tera t ion was identified in the a d e n o m a t o u s polyps f rom 6 cases (3 cases o f inf i l t ra t ing ca r c inoma a n d 3 cases of ca rc inoma in situ) and suspected in the usua l mucosa of 2 cases (de novo).