胃の線状潰瘍はどう変わったか

How Gastric Linear Ulcer Has Changed with Time

　まず，線状潰瘍という言葉の由来についてふれておきたい．

　昭和26年（1951）頃，当時の昭和大学外科において村上忠重教授（現東京医歯大教授）と鈴木武松講師（現東京都品川医師会）が胃の線状潰瘍の病理の研究を始めたのは胃潰瘍の発生理論が知りたかったからであるが，なかなか潰瘍の特徴をつかめなかった．また一番困ったことは潰瘍がなおる病変であるということであった．このような時期に村上教授は鈴木先生の学位論文のテーマとして線状潰瘍を選んだのには次に述べるようないきさつがある．「こんな変な潰瘍（2，3の線状潰瘍，東大例）がある．潰瘍は丸いもの（円形～楕円形）と教えられているが，これも潰瘍の一種らしい．こういう風変わりな潰瘍を研究すると，あるいは本物の成り立ちがわかるかもしれない⁷⁾⁸⁾．」これが胃の線状潰瘍と臨床病理学的（Hauser¹⁾²⁾は1883年，明治16年の論文に線状潰瘍を線状癩痕として記載している）に本格的に取り組むきっかけとなり昭和29年（1954年一胃カメラが世に出た頃）の外科学会総会³⁾で初めて外科的材料を用いて胃の線状潰瘍という言葉を用い公式に発表し認められたという経緯⁴⁾がある．

　Mr. Tadashige Murakami and Takematsu Suzuki defined linear ulcer as that which stretches perpendicularly to the direction of the lesser curvature, of which is its and with 21 length over 3.0cm. But with time, many ideas concerning its definition and concept have evolved. Moreover, studies from different angles have been conducted and various. opinions have come to be given about its pathogenesis and origin. Among them, the fact that the linear scar rate which was only 3% has risen to 28% after 20 years is a great change. There are no conflicting views on the shortening of the linear ulcer, but it is rare that one encounters a clinically typical case these days. N0 changes are seen in the length of the linear ulcer itself, but it is notable that the region of the lesion seen from the pylorus ring has become 1.8cm on the average higher that those of the past. This indicates that the degree of the lesser curvature is lessening. Other changes can be seen in age classification such as the 40 age group showing highest incidence in the past, but the same seen in the 40 to 60 age group these clays. Linear ulcer was not detected in males and females 20 years of age and in females over 70 years of age during this study. Furthermore, that the detection of the case of early cancer from linear ulcer has increased in number with time is a change not to be overlooked.