With a scanning electronmicroscopic study on the lining epithelial cells of the human endometrium in various pathologic conditions, the following results were obtained.
ENDOMETRIAL HYPERPLASIA: The findings of the endometrial surface in the case of endometrial hyperplasia are similar to those in the mid-proliferative phase in the aspects of the protrusion of the surface cells, the openings of endometrial glands and rather slender and densely-packed microvilli. However, semispherical protrusion of the cell surface and hypertrophied microvilli, which are characteristic in early and mid-proliferative phases were never observed. The sizes of the cells faced to the uterine cavity are not uniform through their surface area and the grade of protrusion is 1.4 times as much as those in a proliferative phase.
ENDOMETRIAL POLYPS: No characteristic surface ultrastructure for endometrial polyps were obtained. However, in a few cases, free surface of the endometrial cells are quite flat and wide, being formed into the polygonal shape by the swollen intercellular parts which are supposed to be the terminal-bar. Microvilli on the surface of these cells are around 0.1μ in their length and width, and similar to pin-heads. These findings may suggest the over-distention of the cell surface.
SUBMUCOUS MYOMATA: The findings of the endometrium which lied over submucous myoma-knots are varied depending on the grade of extrusion of these knots into the uterine cavity.
1) In case of slightly protruded myoma-knots; Protrusion on the free cellular surface is slightly smaller than those of the normal endometrium, and it is surrounded by flat free cellular surface with various sizes. The cellular arrangement is irregular.
2) In case of semispherically protruded myoma-knots;The endometuium which covered these knots showed severe atrophic changes similar to those in the senile endometrium, and the cellular arrangement is much more irregular.
3) In case of polyp-like myoma-knots; The endometrium covering the myoma-knots showed the most atrophic findings. The free cellular surface slightly protruded in the shape of triangular or hexangular prisms. Microvilli on that surface looked like pin-heads. The surface of ciliated cells, which ordinally located lower than that of unciliated cells, were at the same level of the latter. Those cilia figured like needles and their number was reduced to the half of that found in the normal cells.
ENDOMETRIAL CANCER: In most cases of endometrial cancer, the rough and irregular surface of cancer cells can be observed among necrotized tissue, since the covering endometrium were almost fallen out. The cell surface are quite large in comparison with those found in other desease and they protruded in the spindle or semioval or cylinder shapes. The cellular arrangement was quite irregular. These findings seem to reflect the atypia of the cancer cells on the surface structure. The sparsely distributed spot-like microvilli on the free surface may be interpreted as the signs of undifferentiation or anaplasia of cancer cells. The findings of the glandular openings are characteristic for each type of cancers and can be used to differentiate one from each other.
1) Tubular adenocarcinoma; The glandular openings show the infundibular recess which transformed into the deep pit and their surroundings are flat. These opening places rather closely.
2) Adenomatous adenocarcinoma; The openings are surrounded by 6-10 cells and elevatted like the bank. Their distribution is quite in high density.
3) Papillary adenocarcinoma; The arbor-like mass of cells which are 40-80μ in diameter protruded into uterine cavity and the glandular openings could never be observed.
THE ENDOMETRIUM WITH IUD: The endometrial surface contacted directly to the IUD showed the recess and the endometrium very close to the IUD showed the slight elevation in comparison with the normal endometrium. In this recess, the covering epithelium

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A clinical use of antibiotics during pregnancy may raise a sereous problem of placental transfer as well as in vivo dynamics of mothers. This problem is particularly noteworthy in cases with renal impairment and it varies depending upon the antibiotics to be used.
In vivo dynamics of cephalosporin C were investigated in normal pregnant women as well as in cases of toxemia, also experimental study using non-pregnant, normal pregnant and renal impaired pregnant rabbits was performed.
The following results were obtained:
1) In vivo dynamics of cephalosporin C was changed by the difference in the side chains of cephalosporin C.
2) In normal pregnant rabbits and normal pregnant women, serum concentration of cephalosporin C showed prolongation as the advance of gestation.
3) Regarding to the normal pregnant and renal impaired rabbits, a CER administrated group showed apparently much greater placental transfer rate, especially the transfer rate to the amniotic fluid was remarkable compairing with CEZ and CET administrated groups.
This result suggested the close relationship between cephalosporin C and serum protein binding rate.
4) In cases of toxemia, half-life of cephalosporin C in serum was prolonged and urinary recovery was decreased.
5) Treated cases of toxemia with clinical improvement caused the shortening of biological half-life and the increase of urinary recovery of CEZ but in 1 case with severe renal impairment the behavior of CEZ failed to alter in a short period of time.

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A study was made of the effect of pregnancy and delivery on the prognosis of cardiac disease mainly in terms of cardiac output before and at the end of kinetic loading during different stages of pregnancy. The results obtained are as follows:
1) In pregnant women suffering from mild cardiac disease, as in normal pregnant women, there was a tendency for cardiac output, stroke volume, heart rate, central blood volume and cardiac work to increase and for time factors such as mean circulation time and electric conductivity to decrease as pregnancy progressed. These parameters, however, were found to adapt themselves to the variation in cardiac function during pregnancy, with compensatory function remaining satisfactory. By contrast, the values of these parameters were labile and varied slowly in pregnant women suffering from severe cardiac disease.
2) The increase in cardiac work during delivery was maximal at the climax of pains, the increment being 55% of the work before onset of pains in normal pregnant women and 42% in pregnant women suffering from mild cardiac disease. The increment in cardiac work was as small as 15% in pregnant woman suffering from severe disease of the heart, indicating a significantly lower ability to work than in the former two groups.
3) The cardiac work load was rapidly decreased after delivery of the child but increased again within 10 minutes of delivery of the placenta, the increment amounting to 43% in normal pregnant women, 21% in pregnant women suffering from mild heart disease and 7% in those having severe disease of the heart. The work load returned to the level before onset of pains between 1 and 24 hours after delivery in all groups. The increase in cardiac work load during delivery lasted approximately 1 to 24 hours.
4) Prognosticating the pregnancy in terms both of the rate of increase of cardiac output at the end of kinetic loading and of the rate of decrease of the appearance time, both pregnancy and delivery were brought safely to an end in most cases having rates of 10% or higher during the initial stage of pregnancy. It was also found that no heart failure occurred during the course of pregnancy in women with rates exceeding 12% and 13% respectively during the middle and late stages of pregnancy, who were able to deliver under the conditions of adequate health care and management.
Based on these findings, the criteria for the prognostication of pregnancy in women suffering from cardiac disease were established while referring, at the same time, to the usefulness of the electric conductivity method as a test of cardiac function in such pregnant women.

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A simple method for determination of myometrial clearance was proposed to make easy the evaluation of utero-placental blood flow. To the woman of late pregnancy, thiamine-propyldisulfide (TPD), 5ml (1ml), was injected into the uterine cervix with a No. 12 Kobak's needle thrust 1cm deep at the 12 o'clock position. The TPD clearance time (TPD time) was decided to coincide with the time from the start of injection to the woman's first sensing of a garlic-like smell of TPD. The results showed: (1) The substance injected in the cervix scarcely moved to the corpus, but cervical blood flow usually conformed readily to the changes in corporeal blood flow in response to the loading of oxytocin or phenylephrine, suggesting cervical approach available for determining myometrial clearance. (2) Experiments with 99mTc corroborate that TPD was almost compatible with ^99mTc in sensitivity and clearance. (3) In women of 35 to 41 weeks of normal pregnancy, the TPD time was usually lagging with pregnancy weeks. (4) Toxemia cases with hypertension as the main symptom and those of chronic or mixed type tended to have delayed TPD times. (5) Women of prolonged pregnancy showed delayed TPD time with a remarkably wide deviation. (6) Women of toxemia or prolonged pregnancy with delayed TPD times were generally associated with a high incidence of low Apgar score.
With the findings of basic and clinical experiments, the author believes that the TPD test is a fovorable, simple and harmless means of clinical assessing utero-placental blood flow.

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[in Japanese]

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[in Japanese]

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