女子非淋菌性尿道炎に於ける病理組織所見に就いて

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Introduction: There are many instances with the symptoms of the unpleasant feeling or pain during urination, the feeling of urinal retention and of a desire to urinate in young female adults without gonorrheal affection. These cases are treated on the base of the bacteriological observations, finding several kind of bacteria, for example, E. coli, various kind of staphylococcus. However, it is not rare that some instances in those patients show the resistance to the antibacterial therapy, or indicate the negative data in the bacteriological examinaeion. Those are treated as cases after cystitis or the bladder neurosis, but some of those cases indicate frequently the reddishness at the urethra or the swelling of the lateral ducts, although the patients show no abnormal findings in the bladder. Therefore, the author observed histo-pathologically the structural changes on the bladder in women in order to disolve the pathogenesis and to find out the suitable treatment for this disorder. Method: A. The cross, horizontal and sagittal sections of the total urethra from dead bodies are prepared as continuous series, and then they are stained with various methods for histo-pathological observations. B. The biopsy from the lateral ducts indicating the reddishness in the urethra of the female patients hodpitalized with the symptoms mentioned above are performed. These materals are histo-pathologically compared with normal materials obtained from dead bodies. Results: The markedly imflamated regions in the parts of the urethra and the lateral ducts are observed in almost half of the materials from dead bodies, and the similar findings are shown in all of the clinical materials. The results obtained in this paper are show as follows: 1) The findings of the imflamation in A group indicate intensive or marked chronic type, showing especially a tendency of localization, although the sphere of the affected regions are different by cases. 2) The similar findings are obtained in the major part of B group. 3) The inflamated area are localized under the mucous membrane of the proper urethra and of the lateral ducts, 4) The pathological findings of the inflamation are divided to two types, being a intensive or marked diffuse cellular infiltration and a intensive follicular, localized cellular infiltration. The most intensive cases show the formation of the so-called lympho-follicle and around this area the surrounding infiltration are formed characteristically. 5) The cellular constitution of the infiltration are mainly small ronnd cells, plasma cells, tissue mononuclear cells, giant phagocytes, and occasionally fibroblasts. Congestion and edema exist in the infiltration area and its surroundings. Furthermore, in the most intensive inflamated area the defferentiation of the substantial tissue are almost impossible due to the accumulation of cells infiltrated. 6) The cellular infiltration is found mainly in the limitted positions which is located between 1.0 cm. and 1.5 cm. distance from the outer opening of the urethra. In this part of the urethra, over twenty or thirty lateral ducts are constructed and the wrinkles of the proper urethra are formed. One more position for the cellular infiltration is recognized in the surrounding location of the urethra cervix, where, although there are small number of the lateral ducts, the wrinkles are markedly formed and the peduliar construction showing semi-follicular, follicular and accumular follicular formations are observed, because of the characteristic papillary structure of the epithelium of the mucous membrane. 7) The results obtained above are similar in the observations on both clinical and dead materials, but in the small number of clinical cases and half of dead materials, slight poitive or negative findings of the inflamation are recognized. Therefore, it is assumed that there is the relationship between the photological findings of the inflamation in the affected area and the syndrome above mentioned, and the further research has to be performed on the base of the fundamental results obtained here.
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女子非淋菌性尿道炎に於ける病理組織所見に就いて

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