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A case of acute necrotic intestinal ischemia with a rectal cancer is described. A 63-year-old woman was admitted to the hospital because of constipation and abdominal pain with an episode of bloody stool. A rectal cancer was detected by clinical examination, but no other significant changes were seen in the colonic mucosa. After administration of a preoperative laxative, severe abdominal pain occurred. On laparotomy, extensive necrotic bowel ischemia revealed in the colon. Rectosigmoidectomy, total colectomy and ileostomy were performed. But, after massive colectomy this patient died of ischemic necrosis of the lower part of the ileum. Pulsation of the main mesenteric artery and of colonic arterial arcade were preserved at the time of surgical operation. Histological examination showed that multiple fresh fibrin thrombus were observed in mucosal or submucosal small vessels. We think that complicated combination of the vascular and intestinal factors might contribute to the pathogenesis in this case.

進行上部胃癌に対する膵体尾部温存術の適応の有無を検討した. 対象は治癒切除のなされた143例である.(11) 番リンパ節の郭清はS2といえども脾動脈幹切除により残った膵体尾部の半連続切片による検索でもリンパ節が見られず, また転移リンパ節からの膵実質浸潤もないので可能である.S2例の潜在性膵実質浸潤は7.3%にすぎない. したがってS2例の大半は膵体尾部温存術の適応がある.S3 (膵), および明らかな (11) 番転移を有する例, また, 潜在性の腹膜再発の危険のあるものには膵脾合併切除術では不十分で, 治癒切除が望めるのなら左上腹部臓器全摘術を行うべきと考える. いずれにしろS2に対する処置が重要である.

The author studied the host-tumor relationship with the cellular and humoral response of the R. E. S. in the patients with gastric carcinoma. The cases with in-creased function of the R. E. S. showed low grade spread and metastasis of carcinoma to lymph nodes, and also better 5 years survival rate. Consequently, disorders of the local and general R. E. S. showed a marked effect on the growth and prognosis of tumor. The author considers that these responses of the R. E. S. in the cancer patient seem to be anti-tumor like result.