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Pathophysiology in the development of stress ulcer with special reference to gastric mucosal defensive mechanism.

Research Project

Project/Area Number 61571129
Research Category

Grant-in-Aid for General Scientific Research (C)

Allocation TypeSingle-year Grants
Research Field Digestive surgery
Research InstitutionSchool of medicine, Kyorin University.

Principal Investigator

KITAJIMA Masaki  1st Dept. of Surgery, School of Medicine, Kyorin University., 医学部外科, 助教授 (90112672)

Co-Investigator(Kenkyū-buntansha) 依田 一郎  杏林大学, 医学部外科, 助手
HIRANO Hiroshi  2nd Dept.of Anatomy, School of Medicine, Kyorin University., 医学部解剖学, 教授 (10086481)
YODA Ichiro  1st Dept. of Surgery, School of Medicine, Kyorin University.
池田 義毅  杏林大学, 医学部第1外科, 助手
大島 厚  杏林大学, 医学部第1外科, 助手 (70129360)
Project Period (FY) 1986 – 1988
Project Status Completed (Fiscal Year 1988)
Budget Amount *help
¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 1988: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1987: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1986: ¥800,000 (Direct Cost: ¥800,000)
Keywordsstress ulcer / gastric mucosal blood flow / H_2receptor antagonist / vagotomy / 胃粘膜エネルギー代謝 / 血小板凝集能 / H_2受容体拮抗剤 / 迷走神経切離術 / 胃粘膜血流 / 粘膜防御機構 / フリーラジカル / 再潅流現象 / 動静脈吻合 / 細胞増殖帯 / レクチン / 細胞回転 / 壁細胞
Research Abstract

Acute gastric mucosal lesions ( AGML ) are wellknown the serious complication of a variety of stresses. Several concepts of the development of stress ulcar have been postulated including gastric acid hypersecretion and H^+ back diffusion. Recently, the focus of investigations on the development of AGML has directed toward from aggressive factor to defensive factor of the gastric mucosa.
The purpose of this study was to elucidate the mechanism in the development of AGML ( stress ulcer ) and reasonable therapeutic procedure with special reference to gastric mucosal defensive factor. After induction of stress ( 30 % of B.S.A ), gastric mucosal blood flow and ATP synthesis decreased significantly compared to sham burn control. Platelet aggrigation was also impaired. These results were supposed to be disruption of gastric mucosal defensive mechanism and to occur bleeding from AGML.
Namely, intraluminal H^+ ion back diffusion increased to the gastric mucosa and AGML developed ul;timately. since H_2 receptor antagonist was comercially avairable, incidence of surgical cases with massive bleeding significantly decreased. However, some of them was not effective for management with H_2 receptor antagonist. Comparative studies wereperformed to evaluate the resonable managements between surgical ( truncal vagotomy with pyloroplasty ) and conservative ( H_2 receptor antagonist ) treatments.
Finally, conservative treatment was not more effective to improve AGML withbleeding than surgery. We concluded that impairment of gastric mucosal blood flow was most important factor in the development of stress ulcer and near total gastrectomy should be selected for surgical treatment of stress ulcer instead of vagotomy and pyloroplasty.

Report

(4 results)
  • 1988 Annual Research Report   Final Research Report Summary
  • 1987 Annual Research Report
  • 1986 Annual Research Report
  • Research Products

    (40 results)

All Other

All Publications (40 results)

  • [Publications] 北島政樹、関学: 消化器科. 7. 461-469 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 北島政樹: 消化器内科. 2. 1525-1534 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 北島政樹 他: Therapeutic Research. 6. 78-85 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 北島政樹 他: Pharma Medica. 4. 73-77 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 北島政樹: Current therapy. 4. 30-34 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 北島政樹: 腹部救急診療の進歩. 6. 171-177 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 北島政樹: "消化性潰瘍の新しい展開" 長尾房大、川井啓一、北島政樹ほか, (98)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Kitajima,M,et al.: "New Trends in Gastroenterology" Sugahara,K., 97-104(410) (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Kitajima M, et al: "Limit of conservative treatment and timing of surgery for gastroduodenal ulcer with bleeding." Geka Shinryo. 59. 510-516 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Kitajima M, et al: "Impairment of gastric microcirculation in stress" J. Clin. Gastroenterol.10. 120-128 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Kitajima M.: "Pathophysiology of acute gastric mucosal lesions." Shokaki Naika.3. 381-1396 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Kitajima M.: "Gastric mucosal defensive mechanism and mucosal blood flow" Shokaki Naika.2. 1525-1534 (1987)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Kitajima M.: "Gastric microcirculatory failure." Saishin Igaku.41. 2790-2795 (1986)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Kitajima M, et al.: Gastric microcirculation and active amines in gastric mucosa in stress.225-228 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 北島政樹 他: 外科診療. 59. 510-516 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] Kitajima,M.;et al.: J.Clin.Gastroenterol.10. 120-128 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 北島政樹 他: 消化器内科. 3. 1387-1396 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 北島政樹 他: 臨床成人病. 18. 38-43 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 北島政樹,木内立男,酒井憲孝: "胃粘膜防御の仕組み、あゆみと展望" 竹本忠良,小林絢三,北島政樹, 67-78 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] Kitajima,M;et al.: "Microcirculation an update" Tsuchiya,M;et al., 225-228 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 北島政樹: Therapeutic Research. 6. 78-85 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: 消化器内科. 2. 1525-1534 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: 消化器科. 7. 461-469 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: 消化管と免疫. 18. 25-29 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: Current Concept in Critical Case. 4. 8-11 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] Kitajima, M.: "New Trends in Peptic Ulcer and Chronic Hepatitis" Inlernational Committee of JSGE, 8 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: "Cimetidin" 三好秋馬, 9 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: "最新消化性潰瘍要覧" 松尾裕, 14 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: "Ranitidine-ランチジンの新しい展開-" 竹本忠良, 18 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: "胃の粘液分泌-その形態と基礎-" 川井啓市, 9 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] Kitajima M: "New Trends in Gastroenterology 1987" Sugahara, K, 10 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: "実験潰瘍" 中沢三郎, 森賀本幸, 7 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 北島政樹: 基礎と臨床. 20. 407-415 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 北島政樹: 最新医学. 41. 2790-2795 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 北島政樹: "胃潰瘍と防御因子" 松尾裕,土屋雅春, 10 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 北島政樹: "胃潰瘍と防御因子" 松尾裕,土屋雅春, 9 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 北島政樹: "胃酸分泌機構と壁細胞受容体拮抗剤" 大江慶治,早川滉, 15 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] Kitajima,M.: "New Trends in Peptic ulcer and Chronic Hepatitis" International Committee of JSGE., 7 (1987)

    • Related Report
      1986 Annual Research Report
  • [Publications] 北島政樹: "胃のサイトプロテクションとその周辺" 竹本忠良,小林絢三, 10 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 北島政樹: "消化性潰瘍の新しい展開" 長尾房大,川井啓市,北島政樹,中村紀夫,三崎文夫, 14 (1986)

    • Related Report
      1986 Annual Research Report

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Published: 1987-03-31   Modified: 2016-04-21  

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