1996 年 59 巻 4 号 p. 236-242
Since the incidence of acute appendicitis seems to vary depending on weather (e. g., the perforation increases under a high atmospheric pressure), we investigated the underlying mechanism.
We classified 112 patients who underwent appendectomy into three groups according to the atmospheric pressure at the time of onset. We found that gangrenous cases (high infiltration of granulocytes) occur more frequently at high atmospheric pressures while catarrhal cases (no infiltration of granulocytes) occurred more frequently at low atmospheric pressures. The physiological variations of granuocytes and lymphocytes in the blood with respect to the atmospheric pressure were then examined in a healthy volunteer. Granulocytosis increases under a high pressure due to the sympathetic activity, whereas lymphocytosis increases under a low pressure due to the parasympathetic activity. Results obtained from gangrenous cases showed much granulocytosis in the blood as well as appendix while catarrhal cases showed much lymphocytosis in the blood and appendix. This seems to imply that granulocytosis induced by the increase in sympathetics activity might be closely related to the onset of gangrenous appendicitis. Even in gangrenous cases, bacteria were not found around the granulocytes in the appendix or in the cytoplasma of granulocytes as observed in electron microscopy. These results may be extremely useful in exploring the etiology of suppurative diseases which are caused without apparent bacterial infections.