N. Iwai

Immunological aspect in experimental pancreatitis

In order to invest igate immune mechanism in pancreat i t is , following exper iments were tried. 1. Eleven ra ts were injected int raper i toneal ly 40 mg of dl-Ethionine every other day for 2 weeks. Serum amylase was elevated markedly and acinus of pancreas was fulled of zymogen granules. Latex agglutination tes t and double gel diffusion tes t were used to prove isoantibody of pancreas . Antibody appeared one month af te r the 1st injection and persis ted to about 5 months , and showed organ specificity. It d iminished on 295 days af te r the 1st injection, and the pancreas of this r a t was histologically normal . 2. Four ra ts of group A were injected in t ramuscu la ry wi th the homogenate of normal pancreas wi th Freund s complete ad juvant once a week for 5 weeks. Four ra ts of group B were injected wi th the homogenate of dl-Ethionine injured pancreas wi th the adjuvant . Four ra ts of group C were injected only wi th the adjuvant . All ra t s of group B showed highly destroyed acinus in pancreas with marked fibrosis. But these changes were observed sl ightly in only 2 ra t s of Group A and 1 ra t of group C. In summary , the dl-Ethionine t reated pancreas resulted in severe changes in the pancreas of the recipient rats. I t was speculated tha t t r ea tment wi th dl-Ethionine caused a change in ant igenici ty of the pancreas and then severe pancreas damage occured.

Limits of cytologic diagnosis in early gastric cancer

Clinical significance of endoscopical features of ear ly gast r ic cancer, especially of IIc type, were discussed in the previous repor t in 1963. In th is report, gross findings of resected specimen were studied comparat ively with endoscopical findings, in 38 lesions of 37 cases of IIc type early gast r ic cancer, macroscopically and histologically. GROSS FINDINGS AND EXISTENCE OF CANCER CELLS Cancer cells were found in the site of rugal in te r rupt ion in 26 lesions of 31 lesions, in gradual s lenderness of rugae in 34 of 35 lesions, in discolorated surrounding mucosa in 2 of 5 lesions, in 12 cases cancer cells overspead beyond the demarca t ing line. SIZE AND SPEC1FIC FEATURES OF THE LESIONS In the large lesions almost all features of early gast r ic cancer could be found, in small lesions the margin of the depress ion and the depress ion itself lost thei r specific fea tures of ear ly cancer, but the features of surrouding mucosal pa t t e rn such as in ter rupt ion of rugae, rugal slenderness, lowering of folds and convergement of folds became more impor tan t to find out smaller early cancer with endoscopy. GROSS FINDINGS AND ENDOSCOPIC FINDINGS In ter rupt ion of rugae was fonnd in 32 lesions in resected specimen and in 33 lesions endoscopically, of 38 lesions. Gradual s lenderness of folds was found in 30 lesions and in 20 lesions, macroscopically and endoscopically. Rough velvetin-like surface of the depress ion was found both in resected specimen and endoscopically well. In the comparat ive study of the IIc type early gast r ic cancer, with resected specimen and endoscopic examination, comsider ing optical factors and blood circulation, the following resul ts were obtained; even in small lesions the findings around the depression can be well observed and detected with endoscopy r a the r easily, and in the diagnosis of the small depressed type cancer, the findings of sur rounding mucosa is very important . The changes in color must not be overest imated.

Immunological aspects of chronic gastritis

A relationship between chronic atrophic gastri t is and degeneration of enteric plexus of the stomach was suggested by investigation of the clinical materials. We investigated this relationship experimental ly by degenerating the enteric plexus of the stomach. Through left gastric artery, body portion of the dog stomach was perfused first with saline, and then with Tyrode solution containing 0.002% mercury dichloride, and kept in a temporary state of anemia for one hour, blood circulation of the stomach being resumed thereafter. Even after 270 days, the stomach of the perfused area showed marked atrophic gastri t is , and enteric plexus showed marked degeneration. In the plexus, about 80 to 90% of ganglion cells were degenerated, and number of the cells decreased to one fourth of the control. Although in this study, some circulatory disturbance might take place, we feel, that the enteric plexus may some role in regeneration of the mucosa, and its degeneration leads to the atrophic change of the mucosa.

A study concerning the mast cell of the gastric mucosa (I)

occurred already in 10 to 21 days in most cases and aggravation thereaf ter appeared to be extremely slow. On the other hand, no changes were seen in about one fourth of the cases. The reason for the rapid appearance of atrophy may be attributable to the circulatory disturbance of the mucosa due to surgery. No relationship was found between postoperative gastr i t is and age, types of anastomosis, original diseases or symptoms.