GASTRITIS EROSIVA AND GASTRITIS VERRUCOSA—Study on morphology and function of varioliform Erosions—

1. On endoscopical observation of the prognosis, variolif orm erosions, characterized by a swollen bulging border with central defect, are classified as disappearing type (gastritis erosiva) and continuous type (gastritis verrucosa). 2. The duration, in disappearing types, usually did not exceed three months. While continuous types persisted longer for forty-five months as the longest time. 3. Endoscopical features ; (a) Disappearing type. The swollen border protrudes less and gradually and its central defect is shallow and wide compaired with the bulging border. (b) Continuous type. The swollen border protrudes sharply, relatively high. Its central defect is small and sharply. bordered. 4. Seasonal appearance : The onset of disappearing types is most frequent on April and October. While continuous types appear every season, though it has peak in October. 5. Age and Incidence; Disappearing types are most often at 30-39 years old, while continuous at 40-49. G. With the advancement of age, the region where both types appear spreads upward like atrophic pattern in gastric mucosae. 7. Endoscopically, continuous types may be classified four types-Type (a)(variolif orm), Type (b) (polypoid), Type (c) (meanderling) and Type (d) (sausage-like). Type (c) and (d) though they are few, have to be differentially diagnosed from early gastric cancer as II a+II c or I type. 8. Bioptical and histological findings ; (a) Gastritis verrucosa at the pyloric glands region-Pyloric gland hyperplasia is predominant and, at the bottom of the erosions, indifferent cell metaplasia is found. (b) Gastritis verrucosa at the body glands region-Foveolar hyperplasia is predominant and sometimes one may find f oveolar irregular erlongation and cystic formation. (c) Disappearing type (gastritis erosiva) -Inflammatoty cellular infiltration with some foveolar hyperplasia is predominant. 9. The difference of the gastric secretory function between those two types by the standard histalog test (Histalog lmg/kg or 50mg). (I) Compared with transient types and persistent types appeared in the same region of the stomach, the former shows higher average than the latter in basal secretion (BSVR, BAO) and stimulated secretion (SVR, AO). (II) Persistent types (gastritis verrucosa)……(1) Persistent types localized in pyloric region show higher average than those spreading to fundic region in both basal secretion and stimulated one. (2) Persistent types with central depression show higher level than those without central depression in basal secretion and stimulated one. Then we can say as follows : persistent types with central depression is in active stage and those with none is in inactive stage. (III) Transient types (gastritis erosiva)… In the same cases, stimulated secretion at the appearing phase of gastritis erosiva is nearly the same as at the disappearing phase. On the other hand, basal secretion (BSVR, BAO) at the appearing phase shows remarkably high level but at the disappearing phase extremely low. So we can guess that transient types are acute phase of gastritis with variolif orm erosions from the gastric secretory study. This fact was confirmed by histological study of gastric mucosa obtained under direct visual biopsy and resected stomach.