女性内性器結核特に卵管結核に就て

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タイトル別名
  • On the Tuberculosis of the Female Internal Genital Organs, with Special Reference to the Tuberculosis of the Tubes

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説明

The author carried out histological examinations on tuberculosis of the female internal genital organs, and obtained following results; 1. Histological findings. The tuberculosis of the tubes were classified into three types, namely the cellular, the caseous and the mixed type, while that of the uteri and the ovaria were classfied into three types, i. e. the nodular, the caseous and the mixed type. In case of the cellular type of the tuberculosis of the tubes the lesions expanded over the most part, namely the entire layers of the mucous membrane, the diseased tissues becoming necrotic and the lesions were rarely restricted to a certain portion. Miliar nodes were not found. In the mixed type, a part or greater part of the mucous membeane was found caseous, and the cellular infiltration around the lesion was conspicious. In cases of the caseous type, however, the entire layers of the mucous membrane showed caseous degeneration, and the inside of tubes were filled with caseous matter. In contrast with the findings in the tubes, the uterine mucous membrane showed a tendency to form scattered miliar nodes. Uterine cellular infiltration was relatively slight (nodular type). The tube and the uterus, thus, revealed outstanding difference in the histological pictures in their initial stages differentiated according to cellular and nodular formation. The tube predominated in the caseous type (52.9%), while the uterus in the mixed (41.7%), the ovarium in the nodular type (50.0%) respectively. The mucous membrane layers were affected in all cases, and their pathological change was very marked and most frequently of the exsudative type (88.2%), and such a markedly severe pathological change seemed to be characteristic for tuberculosis of this tissue. The muscularis layer was affected in 11 cases (64.7%), and it was surmised that most of the lesions were the results of the direct propagation from those in the mucous membrane layer. Their pathologi cal change was generally slight and mostly of the productive type (63.6%). The serosa layer was affected in 9 cases(52.9%), in all of which the peritoneal tuberculosis associated, its intensities eventually conciding with the original disease and accordingly the chronic and productive types predominating (88.9%). The lymphocytes generally predominated with occassional relative predomination of the leucocytes. Monocytes, great phagocytes and great exsudating cells were also seen. The apperance of the great exsudating cells in the tubes would be considered to be signifing the histological origin of these cells. 2. Interrelation between the internal genital organs. As discussed above, marked pathological difference is seen between the initial stage of the tube and that of the uterus, but from the view point that the mucous membranes show the pathological change of exsudative type, while their muscularis and serosa layers show that of productive type, it may be admitted that both organs are common. The pathalogical change taking place in the tube is very intense and mostly of caseous type, while that occurring in the uterus is less intense and mostly of mixed type. Relatively speaking, however, the pathological findings in both organs are almost comparable. 15 cases of the histological examinations for tuberculosis of the mucous membrane of both organs revealed that 80.0% of the tubal tuberulosis concomitantly had the uterine lesions. This proves that there exists intimate relationship between tuberculosis of the tube and that of the uterus, and moreover, as was stated by the above examination, the tubal lesions were the primary while the uterine ones the secondary. On the contrary, no intimate relationship as has been stated above could be recognized between the tube and the ovarium. 3. The relationship of the tuberculosis of tubes to that of other organs, especially of the peritoneum. There. was no case, which showed tuberculosis in the tube only. In all tubal cases, marked tuberculous lesions were

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