한국인 위질환에 있어서의 위점막 장형화생에 관한 연구
A Stndy on the “ Intes t in a liza tion"

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서울대학교 의과대학
Seoul J Med 1969;10(3):17-31
the stomach. It has been recognized since 1883 by
Its orgin and significance have been still not clearly
Two hypothesis have been proposed for the origin
of intestinal type epithelium in the stomach. One
suggests that the intestinal epithelium results from
heterotopic tissue present at birth due to a residual
embryonal cell or tissues. These cells or tissues
differentiate and/or proliferate with disease (heterot•
opia)‘6,52 ,58,78)
The second theory, the more widely held, that the
mucosal tissue is regenerated and/or differentiated
to the intestinal epithelium as a result of chronic
irritations which are not as a congenital one but
acquired (metaplasia).
The chraceteristics of intestinal elements in the
stomach lining are 1) columnar cells, with a striated
border on their free surface. 2) goblet cells , and 3)
Paneth cells and/or argentaffin cells.
The aberrent intestinal epithelium has been observed
in chronic inflammatory conditl6ns, peptic ulcer ,
carcinoma of stomach, polyp and other exert a
destructive effect upon the gastric mucosa by many
authors" 52,78. 88’ “’ 2G. '0, G) It has been considered to
be a premalignant conditions" 31. 52 ,78). This view is
supported by the presence of metaplastic component
such as striated cell borders'!) or enzyme characteristic
of intestinal epithelium").
The other hand, its view is denied by some authors!5,
GO) Recent electron microscopic studies have shown
the abberrent epithelium to be identical in fine
structure and histological arrangement with normal
jejunal epithelium63 • 67) .
In this aspect, like normal jejunal epithlium, the
intestinalized gastric epithelium is able to transport
dietary and micellar lipid from the bowel lumen into
the adjacent lamina propria, in this manner more
lipid can be detected in metaplastic epitheliumGG).
Some authors induced the intestinal epithelium in the
gastric mucosa experimentally by dietary carcinogen7),
histamin8), toxic substance'G) or sclerosing compoundG).
The frequency of intestinalization is various record
in 11 to 100 per cent of the stomach specimen
The author tried to recogniz of intestinalization of
Korean adults by resected specimens on the view of
relationships between the various gastric disease and
metaplasia on clinical and pathological aspects.
Following were the results:
1) In 50 cases of control stomachs obtained by
autopsy in the present study, the following data were
The intestinal metaplasia was recognized in 3 cases
(6% ), of which 2 were combined with gastritis The
fat droplet could not found in any cases.
Mucosal atrophy was found in 3 cases and lymph
follicle was 2 cases out of 6 cases with gastritis of
autopsy specimens.
2) Intestinalization was found in the gastric mucosa
in 193 cases (49.7%) out of 3S9 resected stomach
3) The greatest frequency of intestinal metaplasia
was in the carcinoma of the stomach 56% followed
by stomach ulcer 53%, polyp 50%. gastritis 38%.
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 10 No.3 (1969)
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