腟内容の内分泌学的細胞学的研究
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As a part of endocrino-cytological studies of the vaginal smear, the author investigated changes in the Smear-Index of the vaginal smear stained by Weigert-Shorr's method in various gynecoobstetrical diseeases for the purpose of examining sex hormone activities, particularly, of estrogens, in connection with these diseases.<BR>As a result of fundamental investigations, it was observed that the Smear-Index changed in parallel with the karyopycnosis-index and the acidophilic-index in regard to the menstrual cycle and also that it was the most suitable index showing the changes in the intermediate cells and the deep cells. In animal experiments, staining by the Weigert-Shorr's method was found to indicate definitely the estrus by giving a clear stain of akaryocytes. In castrated rats, it was also observed that the estrogenic effect of minimal amount of Estriol, Estradiol and Conjugated Estrogens given subcutaneously could be detected by this method of staining more accurately and easily than the contional methods of staining.<BR>In clinical investigation of the changes in the Smear-Index, it was revealed that myoma patients generally gave a high Smear-Index value, which seems to give a cytological evidence for a close relationship between the development of myoma and estrogen activity. It was also noticed that the Smear-Index value in a patient with a cervical cancer was nearly the same as in a normal woman, and that it dropped significantly after surgical treatment and radiotherapy. In patients with climacteric disorders, the Smear-Index of a normal level was obtained in more than half of the patients studied. In these cases, hormone therapy caused a lowering of the menopausal-index values, but little changes in the Smear-Index values, suggesting that the deficiency of estrogens is not the only cause of the climacteric disorders. Patients with senile vaginitis gave generally low Smear-Index values which could be raised in parallel with an improvement of the symptons as a result of estriol treatment. It is seen from these findings, the Smear-Index study was found to make it possible to diagnose senile vaginitis accurately and follow the course and results of its treatment. Furthermore, in treating diseases such as vaginitis, cervictis, etc., it was noticed that not only clinical and bacteriological examinations but also the results of the Smear-Index study offered useful informations in diagnosis because bacterial infections and hormone deficiencies are in general known to worsen the intravaginal environment in a manner of circulus vitiosus.<BR>In conclusion, the Smear-Index was found to be a simple and accurate measure of the change in estrogen because of its good staining property and ease in reading. Thus, it may be considered that the Smear-Index study is a useful method of clinical and edocrino-cytological examination in studying changes in estrogen activity, in diagnosis and in evaluating results of treatment of gynecoobstetrical diseases.
- 学校法人 昭和大学・昭和医学会の論文