The American Journal of Digestive Diseases

, Volume 14, Issue 9, pp 655–677 | Cite as

Current concepts of peptic ulceration

  • S. P. Bralow
Progress Report

Conclusion

These observations support the theory that peptic ulceration results from failure of adequate local repair to mucosal injury. The resultant ulcer may be acute or chronic depending upon the duration of the stress or the mucosal contact of the irritative substance and on the ability of the local tissue to achieve cellular homeostasis. The role of acid and pepsin secretion would be secondary, the substances exerting their destructive influence only on susceptible tissue. In 15–20% of the duodenal ulcer patients, chronic damage in the first portion of the duodenum may lead to partial pyloric obstruction resulting in enlargement of the stomach and hyperplasia of the parietal and peptic cell masses. Whether mild impairment of gastric emptying may stimulate continuous gastrin release from the antrum is not known as yet. Such stimulation may initiate further hyperplasia of the PCM and increase gastric secretion. In gastric lesions the apparent normal volume and low acidity of gastric secretion probably results from reabsorption of hydrogen ions through the damaged mucosa.

It is extremely difficult to review the controversial literature pertaining to peptic ulcer genesis without concluding as did an editorial writer forLancet: “He, who investigates the etiology and behavior of peptic ulcer must be prepared for a poverty of rewards such as plagues few other areas of medical research.”123 To compensate for this frustration, we have postulated our own theory based on the inability of the mucosa to maintain cellular homeostasis following mucosal injury.

Keywords

Peptic Ulcer Duodenal Ulcer Gastric Secretion Mucosal Injury Cellular Homeostasis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Blumenthal, I. S.Research and the Ulcer Problem. Report R-336-RC. A Rand Corporation Study, June, 1959. Santa Monica, Calif.Google Scholar
  2. 2.
    Blumenthal, I. S. Digestive disease as a national problem. III. Social cost of peptic ulcer.Gastroenterology 54:86, 1968.PubMedGoogle Scholar
  3. 3.
    Facts on the Major Killing and Crippling Diseases in the United States Today. The National Health Education Committee, Inc. New York, 1966.Google Scholar
  4. 4.
    Piper, D. W. Antacid and anticholinergic drug therapy of peptic ulcer.Gastroenterology 52:1009, 1967.PubMedGoogle Scholar
  5. 5.
    Cruveilhier, J.Anatomic Pathologique du Corps Human au Dexcription avec Figures Lithographiees et Colorees des Diverses Alteration Morbides dont Le Corp Humain est Susceptible (Vol. 1). Baillière, Paris, 1829.Google Scholar
  6. 6.
    Ivy, A. C., Grossman, M. I., and Bachrach, W. H.Peptic Ulcer. Blakiston, Philadelphia, 1950, p. 749.Google Scholar
  7. 7.
    Schwartz, K.Ueber penetrierende magen und jejunalgeschwure.Beitr Klin Chir 67:96, 1910.Google Scholar
  8. 8.
    Grossman, M. I. The pathologic physiology of peptic ulcer.Amer Practitioner Dig Treat 1:134, 1950.Google Scholar
  9. 9.
    Shay, H. Etiology of peptic ulcer.Amer J Dig Dis 6:29, 1961.Google Scholar
  10. 10.
    Cleave, T. L. Peptic ulcer—an entirely new approach based on human evolution.J Appl Nutr 17:23, 1964.PubMedGoogle Scholar
  11. 11.
    Hunter, J. On the digestion of the stomach after death.Phil Trans Roy Soc (London)62:447, 1772.Google Scholar
  12. 12.
    Bernard, C.Lecons de Physiologie Experimentale Applique a la Medicine (Vol. 2). Baillière, Paris, 1856, p. 406.Google Scholar
  13. 13.
    Emås, S., and Grossman, M. I. Production of duodenal ulcers in cats by infusion of porcine gastrin.Gastroenterology 52:959, 1967.Google Scholar
  14. 14.
    Komarov, S. A. The inactivation of pepsin and its relation to peptic ulcer.Rev Gastroent 9:165, 1942.Google Scholar
  15. 15.
    Brodie, D. A. “Neurogenic Factors in Experimental Peptic Ulceration.” InPathophysiology of Peptic Ulcer. Skoryna, S. C., Ed. McGill Univ. Press, Montreal, 1963, pp. 403–411.Google Scholar
  16. 16.
    Brodie, D. A. Progress in Gastroenterology: Experimental peptic ulcer.Gastroenterology 55:125, 1968.PubMedGoogle Scholar
  17. 17.
    Shay, H., Komarov, S. A., Fels, S. S., Meranze, D., Gruenstein, M., and Siplet, H. A simple method for the uniform production of gastric ulceration in the rat.Gastroenterology 5:53, 1945.Google Scholar
  18. 18.
    Menguy, R. Effects of restraint stress on gastric secretion in the rat.Amer J Dig Dis 5:911, 1960.CrossRefPubMedGoogle Scholar
  19. 19.
    Bonfils, S., Liefooghe, G., Rossi, G., and Lambling, A. L'ulcere experimental de contrainte du rat blanc. Analyse des principaux facteurs determinants.Arch Mal Appar Dig 48:449, 1959.PubMedGoogle Scholar
  20. 20.
    Thayer, W. R., Toffler, A. H., Chapo, G., and Spiro, H. M. Inhibition of restraint ulcers in the rat by pyridoxine deficiency.Yale J Biol Med 38:256, 1965.Google Scholar
  21. 21.
    Ritchie, W. P., Jr., Breen, J. J., Grigf, D. I., and Wangensteen, O. H. Effect of decreased levels of endogenous gastric tissue histamine on acid secretion and stress ulcer formation in the rat.Gut 8:32, 1967.PubMedGoogle Scholar
  22. 22.
    Guth, P. H., and Hall, P. Microcirculatory and mast cell changes in restraint-induced gastric ulcer.Gastroenterology 50:562, 1966.PubMedGoogle Scholar
  23. 23.
    Goldman, H., and Rosoff, C. B. Pathogenesis of acute gastric stress ulcers.Amer J Path 52:227, 1968.PubMedGoogle Scholar
  24. 24.
    Polish, E., Brady, J. V., Mason, J. W., Thach, J. S., and Niemack, W. Gastric contents and the occurrence of duodenal lesions in the Rhesus monkey during avoidance behavior.Gastroenterology 43:193, 1962.PubMedGoogle Scholar
  25. 25.
    Foltz, E. L., and Millet, F. E., Jr. Experimental psychosomatic disease states in monkeys. I. Peptic ulcer “executive monkeys”.J Surg Res 4:445, 1964.Google Scholar
  26. 26.
    Kay, A. Effect of large doses of histamine on gastric secretion of HCL; an augmented histamine test.Brit Med J 2:77, 1953.PubMedGoogle Scholar
  27. 27.
    Lambert, R., and Martin, F. Etude statistique de la secretion gastrique stimulee par l'histamine dans l'ulcere gastro-duodenal.Arch Franc Mal Appar Dig 55:45, 1966.Google Scholar
  28. 28.
    Wormsley, K. G., and Grossman, M. I. Maximal histalog test in control subjects and patients with peptic ulcer.Gut 5:427, 1965.Google Scholar
  29. 29.
    Sun, D. C. H. Long-term anticholinergic therapy for the prevention of recurrences in duodenal ulcers.Amer J Dig Dis 9:706, 1964.CrossRefGoogle Scholar
  30. 30.
    Bralow, S. P., Spellberg, M. A., Kroll, H., and Necheles, H. Peptic ulcer in man. I. The ulcer problem.Amer J Dig Dis 17:41, 1950.PubMedGoogle Scholar
  31. 31.
    Berk, J. E. “Medical Treatment of Uncomplicated Gastro-duodenal Ulcer, Drugs Commonly Used, and Their Mechanism of Action.”Peptic Ulcer (ch. 31). Sandweiss, D. J., Ed. Saunders, Philadelphia, 1951, pp. 343–371.Google Scholar
  32. 32.
    Martin, F., and R. Lambert. Role des cellules muqueuses det de leur secretions dans les mecanismes de defense de la paroi gastrique.Acta Gastroent Belg 214:289, 1966.Google Scholar
  33. 33.
    Marks, I. N., and Shay, H. Observations on the pathogenesis of gastric ulcer.Lancet 1:1107, 1966.Google Scholar
  34. 34.
    Capper, W. M., Airth, G. R., and Kilbey, J. O. A test for pyloric regurgitation.Lancet 1:621, 1966.CrossRefPubMedGoogle Scholar
  35. 35.
    Davenport, H. W. Is apparent hyposecretion of acid by patients with gastric ulcer a consequence of broken barrier of hydrogen ions into gastric mucosa?Gut 6:513, 1965.PubMedGoogle Scholar
  36. 36.
    Davenport, H. W. Salicylate damage to the gastric mucosal barrier.New Eng J Med 276:1307, 1967.PubMedGoogle Scholar
  37. 37.
    Chapman, M. A., Werther, J. L., and Janowitz, H. D. Response of the normal and pathological human gastric mucosa to an instilled acid load.Gastroenterology 55:344, 1968.PubMedGoogle Scholar
  38. 38.
    Davenport, H. W. Gastric mucosal injury by fatty and acetylsalicytic acids.Gastroenterology 49:245, 1964.Google Scholar
  39. 39.
    Mackay, I. R., and Hislop, I. G. Chronic gastritis and gastric ulcer.Gut 7:228, 1966.Google Scholar
  40. 40.
    Taschew, T., Majdrakow, G., Nikolow, N., and Stoilow, J. Several morphological and functional changes in patients with gastric and duodenal ulcer.Gastroenterologia (Basel) 104:359, 1965.Google Scholar
  41. 41.
    Holmstrom, B., Wallensten, S., and Frisk, A. Presence of fungi in gastric and duodenal ulcers.Acta Chir Scand 117:215, 1959.PubMedGoogle Scholar
  42. 42.
    Doniach, D., and Roitt, I. M. An evaluation of gastric and thyroid auto-immunity in relation to hematologic disorders.Seminars Hemat 1:313, 1964.Google Scholar
  43. 43.
    Arai, T., and Necheles, H. Effect of alternating acid and alkaline digestive fluids on the gastro-intestinal tract of the rat.Proc Soc Exp Biol Med 119:169, 1965.PubMedGoogle Scholar
  44. 44.
    Kirsner, J. B. Progress in Gastroenterology. Peptic Ulcer—a review of the literature for 1965.Gastroenterology 51:403, 1966.PubMedGoogle Scholar
  45. 45.
    Heatley, N. G. Mucosubstance as a barrier to diffusion.Gastroenterology 37:313, 1959.PubMedGoogle Scholar
  46. 46.
    Lambert, R., Martin, F., Andre, C., Descos, L., and Vouillon, G. Apical localization of glycoproteins in gastric mucous cells.Amer J Dig Dis 13:941, 1968.CrossRefPubMedGoogle Scholar
  47. 47.
    DeGraef, J., and Glass, G. B. J. Chondroitin Sulfate A and Sulfated Glycoproteins in dog gastric secretion from the fundus. I. Electrophoretic and chemical characterization.Gastroenterology 55:584, 1968.PubMedGoogle Scholar
  48. 48.
    DeGraef, J., and Glass, G. B. J. Chrondroitin Sulfate A and Sulfated Glycoproteins in dog gastric secretion from the fundus. II. Turbidimetric method for their quantitation and preliminary results obtained in dog gastric juice and mucus.Gastroenterology 55:594, 1968.PubMedGoogle Scholar
  49. 49.
    Komarov, S. A. Isolation of mucoitin sulfuric acid from canine gastric juice.J Biol Chem 109:177, 1935.Google Scholar
  50. 50.
    Menguy, R. “Regulation of Gastric Mucus Secretion.” InGastric Secretion: Mechanisms and Control. Proceedings of the symposium held at The Faculty of Medicine, University of Alberta, Edmonton, Canada, Sept. 13–15, 1965.Pergamon, New York, 1967, p. 177.Google Scholar
  51. 51.
    Robert, A., Phillips, J. P., and Nezamis, J. E. Gastric secretion and ulcer formation after hypophysectomy and administration of somatotrophic hormone.Amer J Dig Dis 11:546, 1966.CrossRefPubMedGoogle Scholar
  52. 52.
    Code, C. F. “Physiological Recognition and Assays of Gastrone.” InGastric Secretion, Mechanisms and Control. Proceedings of the symposium held at The Faculty of Medicine, University of Alberta, Edmonton, Canada. Sept. 13–15, 1965. Pergamon, New York, 1967, p. 405.Google Scholar
  53. 53.
    Glass, G. B. J., Code, C. F., Kubo, K., and Fiasse, R. “Fractionation of Endogenous Inhibitors of Gastric Secretion (Gastrone) by Physicochemical Means.” InGastric Secretion, Mechanisms and Control. Proceedings of the symposium held at The Faculty of Medicine, University of Alberta, Edmonton, Canada. Sept. 13–15, 1965, Pergamon, New York, 1967, p. 495.Google Scholar
  54. 54.
    Robert, A., and Henninger, M. Acid and mucus secretion in ulcer patients. (abst.)Gastroenterology 52:116, 1967.Google Scholar
  55. 55.
    Piper, D. W., Griffith, E. M., and Fenton, B. H. Gastric mucus secretion in normal subjects and patients with gastric ulcers, gastric carcinoma, and pernicious anemia.Amer J Dig Dis 10:411, 1965.CrossRefGoogle Scholar
  56. 56.
    Doll, R., and Buch, J. Hereditary factors in peptic ulcer.Ann Eugen (London)15:135, 1950.Google Scholar
  57. 57.
    Doll, R., and Kellock, T. D. The separate inheritance of gastric and duodenal ulcers.Ann Eugen (London)16:231, 1951.PubMedGoogle Scholar
  58. 58.
    Clarke, C. A., Cowan, W. K., Edwards, J. W., Howel-Evans, A. W., McConnell, R. B., Woodrow J. C., and Sheppard, P. M. The relationship of the ABO blood groups to duodenal and gastric ulceration.Brit Med Jour 2:643, 1955.Google Scholar
  59. 59.
    Johnson, H. D., Love, A. H. G., Rogers, N. C., and Wyatt, A. P. Gastric ulcers, blood groups, and acid secretion.Gut 5:402, 1964.Google Scholar
  60. 60.
    Clarke, C. A., Evans, D. A. P., McConnell, R. B., and Sheppard, P. M. Secretion of blood group antigens and peptic ulcer.Brit Med J 1:603, 1959.Google Scholar
  61. 61.
    Glass, G. B. J. ABO (H) Blood group substances of the gastric juice in peptic ulcer, cancer of the stomach and atrophic lesions of the gastric mucosa.Gastroenterology 42:443, 1962.PubMedGoogle Scholar
  62. 62.
    Watkins, W. B. Blood group substances.Science 152:172, 1966.PubMedGoogle Scholar
  63. 63.
    Ventzke, L. F., and Grossman, M. I. Response of patients with duodenal ulcer to augmented histamine test as related to blood groups and secretor status.Gastroenterology 42:292, 1962.PubMedGoogle Scholar
  64. 64.
    Fodor, O., Vestea, S., Urcan, S., Pepescu, S., Sulica, L., Iencica, R., Goia, A., and Ilea, V. Hydrochloric acid secretion capacity of the stomach as an inherited factor in the pathogenesis of duodenal ulcer.Amer J Dig Dis 13:260, 1968.CrossRefPubMedGoogle Scholar
  65. 65.
    McConnell, R. B.The Genetics of Gastrointestinal Disorders. Oxford Univ. Press, London, 1966, p. 90.Google Scholar
  66. 66.
    Evans, D. A. P., Horwick, L., McConnell, R. B., and Bullen, M. F. Influence of the ABO blood groups and secretor status on bleeding and on perforation of duodenal ulcer.Gut 9:319, 1968.PubMedGoogle Scholar
  67. 67.
    Langman, M. J. S., Doll, R., and Saracci, R. ABO Blood Groups and Secretor Status in Stomal Ulcer.Gut 8:128, 1967.PubMedGoogle Scholar
  68. 68.
    Weiner, A. S. Blood groups and disease, a critical review.Lancet 1:7234, 1962.Google Scholar
  69. 69.
    Weiner, A. S. Concepts and crucibles.Med Opinion Rev:148, Oct 1967.Google Scholar
  70. 70.
    Bralow, S. P. “Parietal Cell Mass and Gastric Secretion.”The Stomach. Thompson, C. M., Berkowitz, D., and Polish, E., Eds. Thirteenth Hahnemann Symposium. Grune, New York, 1967, p. 132.Google Scholar
  71. 71.
    Cox, A. J., and Barnes, V. R. Experimental hyperplasia of the stomach mucosa.Proc Soc Exp Biol Med 60:118, 1945.Google Scholar
  72. 72.
    Card, W. I., and Marks, I. N. The relationship between the acid output of the stomach following “maximal” histamine stimulation and the parietal cell mass.Clin Sci 19:147, 1960.PubMedGoogle Scholar
  73. 73.
    Marks, I. N., Komarov, S. A., and Shay, H. Maximal acid secretory responses to histamine and its relation to parietal cell mass in the dog.Amer J Physiol 199, 1960.Google Scholar
  74. 74.
    Marks, K. N., Komarov, S. A., and Shay, H. Influence of cholinergic stimuli on gastric secretory responses to histamine in the dog.Amer J Dig Dis 11:122, 1966.PubMedGoogle Scholar
  75. 75.
    Stavny, L. S., Kato, T., Savage, L. E., Harkins, H. N., and Nyhus, L. M. Parietal cell reactivity.Surg Gynec Obstet 118:1269, 1964.PubMedGoogle Scholar
  76. 76.
    Makhlouf, G. M., McManus, J. P. A., and Card, W. The action of the pentapeptide (ICI 50, 123) on gastric secretion in man.Gastroenterology 51:455, 1966.PubMedGoogle Scholar
  77. 77.
    Magee, D. F., Nakajima, S., and Odori, Y. Comment on potentiation.Gastroenterology 55:648, 1968.Google Scholar
  78. 78.
    Wangensteen, O. H., Varco, R. L., Hay, L., Walpole, S., and Trach, B. Gastric acidity before and after operative procedures with special reference to the role of the pylorus and antrum: Preliminary report of clinical and experimental study.Amer Ann Surg 112:626, 1940.Google Scholar
  79. 79.
    Sircus, W. “Considerations on the Effect of Obstruction on Gastric Secretion.” InGastric Secretion—Mechanism and Control. Proceedings of the symposium held at the Faculty of Medicine, University of Alberta, Edmonton, Canada. Sept. 13–15, 1965. Pergamon, New York, 1967, p. 293.Google Scholar
  80. 80.
    Crean, G. P. “Observation on the regulation of the growth of the gastric mucosa.” InGastric Secretion, Mechanisms and Control. Proceedings of the symposium held at The Faculty of Medicine, University of Alberta, Edmonton, Canada, Sept. 13–15, 1965. Pergamon Press, New York, 1967, p. 33.Google Scholar
  81. 81.
    Cox, A. J. Stomach size and its relation to chronic peptic ulcer.Arch Path (Chicago) 54:407, 1952.Google Scholar
  82. 82.
    Marks, I. N. The effect of prolonged histamine stimulation on the parietal cell population and the secretory function of the guinea pig stomach.Quart J Exp Physiol 42:180, 1957.PubMedGoogle Scholar
  83. 83.
    Bralow, S. P., and Komarov, S. A. Parietal cell mass and distribution in stomachs of Wistar Rats.Amer J Physiol 203:550, 1962.PubMedGoogle Scholar
  84. 84.
    Eraslan, S., and Hardy, J. D. Chronic stimulation of the gastric parietal cell mass.J Surg Res 6:137, 1966.PubMedGoogle Scholar
  85. 85.
    Pearl, J. B., Ritchie, W. P., Jr., Gilsdorf, R. B., and Delaney, J. P. The influence of hypothalmic stimulation on gastric mucosal cell population.JAMA 105:281, 1966.CrossRefGoogle Scholar
  86. 86.
    Leonard, A. S., Gilsdorf, R. B., Pearl, J. M., Peter, E. T., and Ritchie, W. B. “Hypothalmic Influence on Gastric Blood Flow, Cell Counts, Acid and Mucus Secretion—Factors in Ulcer Production.” InGastric Secretion, Mechanism and Control. Proceedings of the symposium held at The University of Alberta, Edmonton, Canada, Sept. 13–15, 1965. Pergamon, New York, 1967, p. 149Google Scholar
  87. 87.
    Polacek, M. A., and Ellison, E. H. A comparative study of parietal cell mass and distribution in normal stomachs, in stomachs with duodenal ulcers and in stomachs of patients with pancreatic adenoma.Surg Forum 14:313, 1963.PubMedGoogle Scholar
  88. 88.
    Landor, J. H., Porterfield, J. F., and Wolff, W. S. The parietal cell response to chronic gastric secretory stimulation.Surg Gynec Obstet 122:61, 1966.PubMedGoogle Scholar
  89. 89.
    Melrose, A. G., Russell, R. I., and Dick, A. Gastric mucosal structure and function after vagotomy.Gut 5:546, 1964.Google Scholar
  90. 90.
    Baker, B. I., and Bridgman, R. M. The histology of the gastro-intestinal mucosa (rat) after adrenalectomy or administration of adrenocortical hormones.Amer J Anat 94:363, 1954.CrossRefPubMedGoogle Scholar
  91. 91.
    Bralow, S. P., Komarov, S. A., and Shay, H. Effect of total adrenalectomy on gastric secretion and parietal cell mass in the rat.Amer J Physiol 206:1309, 1964.PubMedGoogle Scholar
  92. 92.
    Necheles, H. The phenomenon of peptic ulcer.Amer J Dig Dis 16:237, 1949.Google Scholar
  93. 93.
    Virchow, R. Historisches, Kritisches and Positives zur Lehre der Unterleibsaffektionnem.Arch Path (Chicago) 5:281, 1853.Google Scholar
  94. 94.
    Cox, H. T., Poller, L., and Thomson, J. M. Gastric fibrinolysis a possible etiological link with peptic ulcer.Lancet 1:1300, 1967.CrossRefPubMedGoogle Scholar
  95. 95.
    Rudick, J., Guntheroth, W. G., and Nyhus, L. M. “Recent Observations on Gastric Blood Flow and Acid Secretion.” InGastric Secretion, Mechanisms and Control. Proceedings of the symposium held at The Univ. of Alberta, Edmonton, Canada, Sept. 13–15, 1965. Pergamon, New York, 1967, p. 53.Google Scholar
  96. 96.
    Jacobson, E. D., Swan, K. G., and Grossman, M. I. Blood flow and secretion in the stomach.Gastroenterology 52:414, 1967.PubMedGoogle Scholar
  97. 97.
    Palmer, E. D., and Sherman, J. L. Hypoxia of abnormal physiologic origin as the final common pathway in gastro duodenal ulcer genesis.Arch Intern Med (Chicago) 101:1106, 1958.Google Scholar
  98. 98.
    Gius, J. A., Boyle, D. E., Congdon, R. H., and Boyd, W. C. Studies on the blood vessels in peptic ulcer. The ulcer vessel nest.Arch Surg (Chicago) 91:221, 1966.Google Scholar
  99. 99.
    Gius, J. A., Boyle, D. E., Castle, D. D., and Congdon, R. H. Vascular formations of the lip and peptic ulcer.JAMA 183:725, 1963.PubMedGoogle Scholar
  100. 100.
    Müller, O., and Heimberger, H. Uber die entstehung des runden magengeschwurs.Deutsch Z Chir 187:33, 1924.Google Scholar
  101. 101.
    Croft, D. N., Pollock, D. J., and Coghill, N. F. Cell loss from human gastric mucosa measured by the estimation of deoxyribonucleic acid (DNA) in gastric washings.Gut 7:333, 1966.PubMedGoogle Scholar
  102. 102.
    Kim, Y. S., Kerr, R., and Lipkin, M. Cell proliferation during the development of stress erosions in mouse stomach.Nature 214:1180, 1967.Google Scholar
  103. 103.
    Ludwig, W., and Lipkin, M. Biochemical and cytologic alterations in gastric mucosa of guinea pigs under restraint stress.Gastroenterology 56:895, 1969.PubMedGoogle Scholar
  104. 104.
    Hooper, C. S., and Blair, M. The effect of starvation on epithelial renewal in the rat duodenum.Exp Cell Res 14:175, 1958.CrossRefPubMedGoogle Scholar
  105. 105.
    MacDonald, W. C., Trier, J. S., and Everett, N. B. Cell proliferation and migration in the stomach, duodenum, and rectum of man: radioautographic studies.Gastroenterology 46:405, 1964.PubMedGoogle Scholar
  106. 106.
    Leblond, C. P., and Carrierr, R. The effect of growth hormone and thyroxine on the mitotic rate of the intestinal mucosa of the rat.Endocrinology 56:261, 1955.PubMedGoogle Scholar
  107. 107.
    Räsanen, T. Fluctuation in the mitotic frequency of the glandular stomach and intestine of rat under the influence of ACTH, glucocorticoids, stress and heparin.Acta Physiol Scand 58:201, 1963.PubMedGoogle Scholar
  108. 108.
    Teir, H. Editorial: Mitotic rate and cell differentiation in the diseased human gastric mucosa.Gastroenterology 45:536, 1963.Google Scholar
  109. 109.
    Teir, H. “Mitotic Homeostasis and Physiological Control of Cell Renewal in Healthy and Diseased Gastric Mucosa.” InGastric Secretion, Mechanisms and Control. Proceedings of The symposium held at Univ. of Alberta, Edmonton, Canada. Sept. 13–15, 1965. Pergamon, New York, 1967, p. 25.Google Scholar
  110. 110.
    Bullough, W. S., and Rytoma, T. Mitotic homeostasis.Nature 205:573, 1965.Google Scholar
  111. 111.
    Clark, R. H., and Baker, B. C. Effect of adrenalectomy on mitotic proliferation of gastric epithelium.Proc Soc Exp Biol Med 111:311, 1962.PubMedGoogle Scholar
  112. 112.
    Stevens, C. E., and Leblond, C. P. Renewal of the mucous cells in the gastric mucosa of the rat.Anat Rec 115:231, 1953.CrossRefPubMedGoogle Scholar
  113. 113.
    Baker, B. L. Editorial: Cell replacement in the stomach.Gastroenterology 46:202, 1964.PubMedGoogle Scholar
  114. 114.
    Lambert, R., Martin, F., Andre, C., Deacos, L., and Vouillian, G. Apical localization of glycoproteins in gastric mucous cells.Amer J Dig Dis 13:941, 1968.CrossRefPubMedGoogle Scholar
  115. 115.
    Townsend, S. F. Regeneration of gastric mucosa in rats.Amer J Anat 108:133, 1961.CrossRefGoogle Scholar
  116. 116.
    Hunt, T. E., and Hunt, E. A. Thymidine-H3 radio-autographs of the gastric mucosa of the rat after stimulation with compound 48/80. (abst.)Anat Rec 139:240, 1961.Google Scholar
  117. 117.
    Komarov, S. A., Bralow, S. P., Shay, H., and Boyd, E. Relationship between gastric secretion and behavior in chronic fistula rats.Amer J Physiol 205:230, 1963.PubMedGoogle Scholar
  118. 118.
    Ragins, H., and Liu, S. M. Gastric mucosal mast cells in the common laboratory animals and man.JAMA 2:654, 1968.CrossRefGoogle Scholar
  119. 119.
    Johnson, L. R. Source of the histamine released during damage to the gastric mucosa by acetic acid.Gastroenterology 54:8, 1968.PubMedGoogle Scholar
  120. 120.
    Brodic, B. B., Beaven, M. A., Erjavec, F., and Johnson, H. L. “Uptake and release of H3-histamine.” InMechanisms of Release of Biogenic Amines. Uvnas, B., Ed. Pergamon, New York, 1965, p. 401.Google Scholar
  121. 121.
    Bullough, W. S. The energy relations of mitotic activity.Biol Rev 27:133, 1952.Google Scholar
  122. 122.
    Kowalewski, K. “Activity of Some Respiratory Enzymes in Mitochondria of Steroid Treated Rats” (Vol. 51).Excerpta Medica Foundation, Amsterdam, 1967, p. 72.Google Scholar
  123. 123.
    Editorial.Lancet 1:1313, 1967.Google Scholar
  124. 124.
    Crean, G. P., Hogg, D. F., and Rumsey, R. D. E. Hyperplasia of the gastric mucosa produced by duodenal obstruction.Gastroenterology 56:193, 1969.PubMedGoogle Scholar
  125. 125.
    Crean, G. P., Marshall, M. W., and Rumsey, R. D. E. Parietal cell hyperplasia induced by the administration of pentagastrin (ICI 50, 123) to rats.Gastroenterology 57:147, 1969.PubMedGoogle Scholar

Copyright information

© Hoeber Medical Division • Harper & Row 1969

Authors and Affiliations

  • S. P. Bralow
    • 1
  1. 1.From the Department of Medicine, Gastrointestinal SectionTemple University School of MedicinePhiladelphia

Personalised recommendations