産婦人科の進歩

白鼠腟壁の電子顕微鏡的研究

小林茂美

1973 年 25 巻 5 号 p. 513-548
発行日: 1973/09/01
公開日: 2011/10/11

DOIhttps://doi.org/10.11437/sanpunosinpo1949.25.513

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白鼠腟壁の扁平上皮は, 一般の重層扁平上皮と同様に基底細胞層, 傍基底細胞層, 棘細胞層, 浅棘細胞層, 角層 (角化細胞層) の各層からなり, 性周期に伴なう内分泌環境の変化に応じて極めて明らかな変化を示し, 細胞再生系を研究するには好適な試料の一つであるので, その正常性周期, 妊娠時ならびに去勢および去勢後 steroid 投与時における変化を電顕的に研究した.
白鼠正常性周期を上皮期, 上角期, 角化期および後期, 間期に分類したが上皮期から上角期にかけて, 基底細胞では ribosome, 深棘細胞では ribosome, tonofilament, desmosome がそれぞれ増加し, 角層が出現して緻密層と剥離層の分化が見られた. しかし浅棘細胞における keratohyalin 顆粒は少数で membrane coating granule および角層の keratine pattern は余り著明ではなかった.
角化期から後期にかけて細胞質小器官がやや減少し, 浅棘細胞の空胞構造も著明ではなかった.
妊娠時には深および浅棘細胞層の肥厚が著明でかつその細胞質内に多数の空胞が出現し蜂巣状構造を呈し, いわゆる粘液形成の像がみとめられた.
去勢により萎縮した腟上皮は estrogen 投与により基底層では早期より細胞小器官が増加し, 全体として肥厚するとともに表層の角層細胞が再形成され, progesterone 投与により, 深および浅棘細胞層の肥厚と細胞質内小器官, ことに蜂巣状空胞構造の粘液形成像の著明な出現がみられた.
以上の実験結果により白鼠腟壁扁平上皮において estrogen は細胞小器官ことに ribosome, tonofilament, および desmosome の増加と角層の形成を促進し, progesterone は estrogen との協同, あるいは単独でも大量投与により深および浅棘細胞層における ribosome, 小胞体, 粘液空胞の形成を促し, 腟壁扁平上皮における特異な粘液化変性を出現せしめた.

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Prostaglandin F_2α による分娩誘導

宮本紀男, 真鍋幸夫, 中嶋晃, 石川愿, 藤村弘, 竹村晟

1973 年 25 巻 5 号 p. 549-555
発行日: 1973/09/01
公開日: 2011/10/11

DOIhttps://doi.org/10.11437/sanpunosinpo1949.25.549

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Continuous drip infusion of prostaglandin F_2α was performed in 28 cases ranging from 39 to 42 weeks of gestation. Labor was successfully induced in all cases, and in 22 cases delivery was terminated during the treatment. The success rate was 78.6%. Success to delivery was greatly influenced by the selection of patients, i. e. parity and Bishop score of each case. Multiparas with large Bishop score had higher success rate than primiparas with smaller Bishop score. In addition to the appropriate doses and infusion speed of the medicine, the selection of patients with the socalled “Mature Uterine Cervix” is necessary to attain high success rate.
The side effects are uterine hypertonus, nausea, vomitting, diarrhea, and others, and some 40% of all cases had some of these complications. In 6 cases infusion had to be suspended during the treatment because of these complications. There seems to be close correlation between the uterine and intestinal effects of prostaglandin F_2α with regards to the infusion doses. Significant leucocytosis was noted in several cases, but no other apparent effects were revealed in the maternal laboratory values. No significant effects were seen on the newborn infants.

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新生児胃穿孔の1例

林要, 森川肇, 平井至, 西本弘之, 金沢精一, 田中淳

1973 年 25 巻 5 号 p. 557-561
発行日: 1973/09/01
公開日: 2011/10/11

DOIhttps://doi.org/10.11437/sanpunosinpo1949.25.557

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Perforation of the stomach in new-born infant was thought relatively uncommon, but recently many cases on this disorder were reported including some cases repaired surgically.
Among the causes, perforation of ulcers is the most readily explained, but it is said the one third of those perforations are secondary to the defects of the gastric musculature.
Even in the cases of secondary perforation, they are associated with abnormalities in the lower gastrointestinal tract, such as atresia of the pylorus or intestinal obstructions.
This disease is common in premature babies and shows high mortality, and usually occurs within five days after birth and the prognosis depends upon early diagnosis and treatment.
From these points, obstetricians should be familiar with patho-physiology and symptoms of this disorder.
Recently we experienced a case of gastric perforation with successful surgical repair and it is reported here.

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