Yoshinobu Fuse

Thickness of Brunner's Glands and Its Clinical Significance in Duodenal Ulcer Disease

The thickness of Brunners glands was measured with an ocular micrometer in 75 cases of surgically resected duodenal ulcer and in 75 autopsy cases (control group). Endoscopic findings before operation were also studied. Maximum mean thickness of Brunners glands in the control group was 1.54 +/- 0.38 mm (mean +/- SD), and no regional difference in thickness was noted. The thickness of Brunners glands in the duodenal ulcer group was widely distributed, from 0.5 mm to 5.0 mm, and the average value was 3.0 +/- 1.0 mm, with a statistically significant difference from that of the control group. In most duodenal ulcer cases Brunners glands were thickest within 1 cm from the center of an ulcer. Only six cases of duodenal ulcer (8.0%) showed a diffusely thin layer of Brunners glands, less than 1.5 mm thick. These results show that the Brunners glands become hyperplastic in duodenal ulcer patients, especially near the ulcer. In the healed ulcer Brunners glands were thin at the center of an ulcer scar, and the average thickness was 0.42 +/- 0.26 mm. This histologic finding corresponded to the depressed scarred area observed endoscopically, suggesting a decreased mucosal resistance at this area.

Healing Process of Experimental Esophageal Ulcers Induced by Acetic Acid in Rats

We studied the healing of acetic acid-induced esophageal ulcers in rats with respect to the cellular kinetics. Esophageal ulcers were induced by topical application of acetic acid to the serosal surface. Well-demarcated circular or elliptical ulcers had developed by day 3 after the acid treatment. These ulcers began to decrease in size from day 7 and had healed by day 14. Histological and cellular kinetic findings, with bromodeoxyuridine (BrdU), were degeneration of the esophageal mucosa on day 1 and ulcer formation on day 3, with an increase in the number of BrdU-labeled cells in the esophageal mucosa around the ulcer. On day 7, regenerated epithelium was found to extend towards the ulcer base and the regenerated epithelium had become thicker, with papilla formation, by day 10. On day 14, the ulcer base was covered with thickened regenerated mucosa, with a decrease in the number of BrdU-labeled cells. Marked proliferative activity of the regenerated mucosa and thickening of the esophageal mucosa, with papilla formation, were observed during the healing process.

Autoradiographic study on healing process of cysteamine-induced duodenal ulcer in rat. Possible importance of Brunner's glands in ulcer healing

The healing process of cysteamine-induced duodenal ulcer was studied by [3H]thymidine autoradiography. After the development of ulcer in the duodenum, cell proliferation was markedly activated not only in the crypts but also in the Brunners glands near the ulcer. In the initial stages of ulcer healing, they both contributed to form the surface covering regenerating epithelium. Granulation tissue also proliferated at the base of the ulcer. In later stages of ulcer healing, new crypts were formed in the floor of the ulcer. New villi regenerated from these crypts and Brunners glands regenerated by proliferationin situ. The ulcer base then was completely covered with new villi and granulation tissue was replaced by dense fibrous connective tissue. The present study suggested that the Brunners glands, together with the crypts of Lieberkühn, play an important role in the healing process of cysteamine-induced duodenal ulcer.

Thickness of Brunner’s glands and its clinical significance in peptic ulcer diseases

SummaryThe thickness of Brunner’s glands was measured using an ocular micrometer in 297 cases of surgically resected peptic ulcer and in 120 autopsy cases (control group). The mean maximum thickness of Brunner’s glands in the control group was 1.55±0.37mm (mean±SD) and no difference in thickness was noted for each decade of age. The mean maximum thickness of Brunner’s glands in patients with gastric ulcer, duodenal ulcer and gastroduodenal ulcer was 2.34±1.06, 3.18±1.07 and 3.24±1.05mm, respectively. When an ulcer is within the duodenum, Brunner’s glands near the ulcer were thicker than those contralateral to it. In patients with gastric ulcer, Brunner’s glands were the thickest in the pyloric ulcer group and negative correlation was noted between the thickness of Brunner’s glands and the distance to the ulcer from the pyloric ring. Since gastric acidity is supposed to be lower when an ulcer is located more proximally, these results suggest that Brunner’s glands become hyperplastic not only with the presence of an ulcer in the duodenum but also by acid hypersecretion of the stomach.

Possible Mechanisms of Diethyldithiocarbamate-Induced Gastro-Duodenal Mucosal Damage in Rats

A single s.c. injection of diethyldithiocarbamate (DDC, 1 g/kg) induced not only gastric but also duodenal mucosal damage in rats. DDC induced marked decreases in gastric acid output, gastro-duodenal mucosal blood flow and transmucosal potential difference prior to the development of mucosal lesions. Superoxide dismutase activity in the gastro-duodenal mucosa was also inhibited, while catalase and glutathione peroxidase activities gradually increased after the administration of DDC. These results suggest that a decrease in mucosal defensive mechanisms plays an important role in the development of DDC-induced gastro-duodenal mucosal damage and that oxygen-derived free radicals may also participate in the development of this mucosal damage.