著者

浜西 正三 Shozo HAMANISHI 神戸大学医学部産科婦人科学教室:神戸大学医学部解剖学第二講座 Department of Obstetrics & Gynecology Kobe University School of Medicine:Department of Anatomy Division 2 Kobe University School of Medicine

出版者

日本産科婦人科学会

雑誌

日本産科婦人科學會雜誌 = Acta obstetrica et gynaecologica Japonica (ISSN:03009165)

巻号頁・発行日

vol.29, no.5, pp.500-506, 1977-05-01

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ラットの着床周辺期における胚と内膜の表面構造の変化について,走査型電顕的観察を行ない,次の成績を得た. 1) 正常着床期の子宮内膜上皮表面では,規則正しく配列する微絨毛は,長短不整となり,先端部が風船状に膨化した後,急激に屈曲,短小,不整化する.細胞質突起はこぶし状,入道雲状で,数が増えた後,壁が増し,縮小扁平化して,adhesion stageに微絨毛の原形消失と相呼応し,不整粗大な鋸歯状・海草状突起へ移行する. 2) 遅延着床時内膜では,比較的繁茂する微絨毛と巨大細胞質突起を認めるが,これは妊卵(原胚子)や卵管液の作用にもよるものではなく,progesteroneの作用による.またそのestrogenによる着床誘導時には,早期(4~8時間)に一過性の分泌亢進像を呈した後,後期(16~24時間)に平低下する. 3) 微絨毛先端部の風船状膨化はestrogen作用下に生ずるmicroapocirine像と考えられる. 4) 腺開口部構造が反間膜側内膜の側壁部に,孤立した1細胞面積分の陥凹や,舟底状の斜坑状の陥,裂隙として認められる.一方,上皮細胞がロゼット状に集合した所で,細胞間隙からの分泌を示唆する所見が得られた,これら2者ともにestrogenの作用下で顕著となる. 5) 胚の透明帯の表面は,素焼の陶器様で粗〓である.透明帯消失後,胚の表面に均等に生えていた微絨毛は,胚自体の増大や栄養膜細胞の増数に伴い消失してゆき,胚の表面は平滑となる. これら一連の所見は,胚と内膜が三次元的な観点からも,互いにより平滑な面で最初の接触を遂行していることを示すものである.The structural changes of the surfaces of the endometrium and the blastocyst during the implantation in rats were studied scanning electron microscopically. Findings obtained were as follows: 1) In the pre-attachment stage, the microvilli of the endometrial luminal epithelium lose their distal ends. Thereafter they shorten rapidly and become bent irregularly. Cellular protrusions are nodular at first, then increase in number with multiple folds and flanges, subsequently become small and flattened. In the adhesion stage, they become serrated and show seaweed-like appearance. 2) During delayed implantation, caused by dosing of progesterone, relatively abundant microvilli and giant cellular protrusions are observed. During the induction of implantation with estrogen, the endometrium assumes transiently the secretory phase, and then becomes flattened. 3) Many structures suggesting the glandular orifice an also that seeming to the intercellular secretion are observed, especially under the influence of estrogen. 4) After the shedding of zona pellucida, the microvilli of the trophoblast gradually disappear. In the adhesion stage, the surface of the blastocyst become smooth.

著者

阪井 胖 冨沢 明子 小林 八郎 浜西 正三 岩井 敏子

出版者

近畿産科婦人科学会

雑誌

産婦人科の進歩 (ISSN:03708446)

巻号頁・発行日

vol.42, no.5, pp.593-602, 1990 (Released:2011-07-05)

参考文献数

12

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1. i) In threatened premature labor, viewed from a uterine contraction wave and a subjective complaint obtained by means of a cardiotocogram, B waves and L waves were observed in many cases when the patient complained of a lower abdominal pain and/or lumbago.With these pains, or with a complaint of abdominal distension, the threatened premature labor is possible, and an objective evaluation of uterine contractions by means of the cardiotocogram is necessary.The uterine contraction was recorded with a cardiotocogram.The recorded waves were evaluated by Nakae's classification (1978), and given points for each wave : 1 point for A wave, (31-60 sec), 1.5 point for B wave (61-180 sec).ii) From this study, as a prime therapeutic factor, the wave of uterine contractions with less than two contractions (A and/or B waves) in 30 minites, i.e. below 3 points of contraction is provided.2. Correlativity between these points and lower abdominal pain and lumbago is heightened and subjective complaints are increased as the point of uterine contraction becomes larger.3. In the case of 4 points of contraction or more, subjective complaints with lower abdominal distension, lower abdominal pain and lumbago were considerably increased.4. In the case of uterine contractions with more than 7 points having such pains as lower abdominal pain and lumbago, the patient was prematurely delivered at a relatively earlier time.5. The uterine contraction, one of the four factors in Tocolytic Index (T.I.) (Baumgarten, 1974) which is frequently used in foreseeing pre-term delivery mentions just irregular or regular. To assure more concrete determination, we studied the uterine contraction points in order to apply them to T.I.