PATHOPHYSIOLOGY OF THE RECURRENCE OF DUODENAL ULCER: Quantitative Ultrastructural Analysis of Parietal Cells after Tetragastrin

Twenty patients with duodenal ulcer were divided into two groups with endoscopic follow-up study. One group includes 12 patients with recurrent duodenal ulcer, an the other includes 8 patients with non- recurrent duodenal ulcer. Endoscopic examination was performed in the two groups and 8 healthy subjects. Biopsy specimens were collected before the injection of 4μg/kg tetragastrin, at 5, 15 and 30 minutes after the injection. Using the point-counting method of Weibel, we analysed serial changes in subcellular structures of parietal cells after tetragastrin. The volume densities of intracellular canaliculi (Vic), tubulo-vesicular structures (Vtv) and mitochondria (Vm) were measured. The results were as follows. 1. The recurrent group showed more rapid increase in Vic and decrease in Vtv than those of the other two groups. 2. In all groups, Vm exhibited no change. 3. No qualitative difference was found in the cytoplasmic organells among the three groups. These results suggest that the individual parietal cells of the recurrent group are more sensitive to tetragastrin than those of the other two groups.