間脳「レ」線照射の統計的観察
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概要
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Since the X-ray irradiation of the diencephalon was utilized to the hypophysis of rabbits by Geller (1921), it has been applied in the gynecological field as well to the atrophy of genital organs, anomaly of menstrual cycle, dysmenorrhea, hemorrhagic metropathy and sterility etc. and various reports have been issued concerning its effect. In Japan too, its reports were made by Yasui and many others, but none of them has given so many clinical observations as yet. Recently the significance of the diencephalon-hypophysis-ovary system has been increasing in the field of the sex hormone research, and to that effect the rescrutiny of the X-ray irradiation of the diencephalon is of deep import. The author, in the Department of Obstetrics and Gynecology, School of Medicine, Chiba University, tried to carry on investigations in the prognosis of the X-ray irradiation of the diencephalon by correspondence with 3776 out of 8696 patients who had visited the hospital with the chief complaints of amenorrhea, anomaly of menstrual cycle, dysmenorrhea and sterility during 23 years from 1935 to 1957 and received replies from 542 patients, from the result of which the author made the statistical observations. The irradiation method was that improved from Koplan's method, by which they irradiated 170 r to either side respectively on the area of 2.5 cm in radius with the center of Sahler's point, performing it 3 times every 10 days. As the result of that, the X-ray irradiation of the diencephalon was applied to the 13 out of 44 patients who had had amenorrhea proved to be effectively responsive to that. Being compared and contrasted with these, 13 cases (41.9 %〜), which improved spontaneously, out of 31 non-irradiated cases were investigated, proving from the standpoint of the theory of statistical inference that the X-ray irradiation therapy of the diencephalon was effective for the amenorrhea and irregularity of menstrual cycle. Then, 71 out of 247 cases with dysmenorrhea were irradiated with the result that 27 cases (38.0 %) improved symptomatically after the irradiation. These were contrasted with 58 cases (33.8 %}, which became better by themselves, out of the non-irradiated 176 patients who visited the hospital during the same period and the effectiveness of such irradiation for dysmenorrhea was ascertained. With further subdivision of these results, the effectiveness of the irradiation of the diencephalon was observed in the high percentage of 20 cases (76.9 %) out of 26 cases with dysmenorrhea accompanied by hypoplasia uteri. 530 patients who came with the chief complaint of sterility were given various treatments and the irradiation of the diencephalon was applied to 73 patients, 41 out of whom could conceive after the irradiation. These were compared with 108 patients (45.8 %), who achieved pregnancy, out of 236 sterility patients who had not been treated with the diencephalon irradiation etc. and the fertilization rate was obviously high in the irradiated cases. The comparison of the irradiated with the non-irradiated groups of sterility is considered to suggest the effectiveness of the irradiation for the sterility from the fact that the irradiated group had the higher fertilization rate although the latter had more or less insufficiency of ovarian function and the former exceled in the sterility character. Considering from the above results, the irradiation of the diencephalon for the sterility case with ovarian dysfunction is considered to be at least effective. There still remain many unknown points to be solved as to its effectuating mechanism, but as far as the irradiated region is concerned, both the diencephalon and hypophysis are naturally exposed to the irradiation and the efficacy of the treatment for the above-described amenorrhea, anomaly of menstrual cycle and dysmenorrhea etc. suggests that the X-ray irradiation of the diencephalon acts on the center of the autonomic nervous system with the good effect on the diseases of that system on the one hand and hormonic disorders on the other hand by the simultaneous nervous stimulation influencing on the hypophysis. Furthermore the sex center reported to be located in the hypophysis attracting attention of late is stimulated as well and these combined actions influence on the hypophysis-ovary system, suggesting it to be effective for disorders of neurogenic or hormonic origin. The explanation of such mechanism still remains in the stage of reasoning. From the result of the statistical observation covering 23 years, some value is believed to consist in the treatment of the X-ray irradiation therapy of the diencephalon to the sterility case accompanying the amenorrhea, anomaly of menstrual cycle, dysmenorrhea and insufficiency of ovarian function.
- 1960-11-28