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6 1 ) Birnberg et al; Am. J. Obst. Gyn., 54 :88E ) Bromberg, Y.M. & Bercovici, B. : Acta Endocrin., 7; 71, : 33, 1956; Fertil. and Steril. 3) Fluhmann, C. F. : The management of menstrual Philadelphia Disorders p153, W.B. Sanders CO. 4) Goldzieher, T.W., Moses, L.E. & L. T. Ellis; J. A. M. A., 180; ) Hamblen, E. C.; Endocrine Gynecology, Springfield ) Hoffman, J.; Med. Clinics Noth. Amer ) Kupperrr an, H. S.; Obst, & Gynecol.,1: 650, ) Pincus, G, et al; Amer. J. Obst.Gynec., 75 :1334, ) Rakoff, A.E.; Med. Clinic of Noth Amer., p ) Sutherland, A. M; Med. J. Australia, 1 : 819, ) Tuisky; Prog. in Clin, Endocrin ) Wharton : Ggnecology, W. B, Saunders Co,,

7 philadelphia & London ) Zondek, B. & S. Rozin; Surg. Gynec. & Obst, ) Zondek, B.; J. A. M. A., , 1,942. STUDIES OF DYSFUNCTIONAL UTERINE BLEEDING SATORU KONDO Depatment of Obstetrics and Gynecology, Gunma University School of Medicine, Maebashi, Japan (Director : Prof. Seiichi Matsumoto) It is concluded the following rtesults from the clinical investigations of 479 patients diagnosed as the dysfunctional uterine bleeding, the statistical studies of 1769 patients who have the chief complaint of abnormal uterine bleeding, the comparative studies between endometrial histopathology and clinical symptomes in 116 patients of dysfunctional uterine bleeding, endometrial histologic studies about artificial withdrawal bleeding induced by various dosage and administered duration of estrogen and/or gestagen, and correlation between bleeding and basal body temperature or mucus discharge in 19 patients of intermenstrual bleeding. (1) So called "dysfunctional uterine bleeding" diagnosed in the out patients clinic holds menstruation itself or menstrual disorders. (2) Dysfunctional uterine bleeding has various clinical manifestations by age or the experience of delivery. (3) Sixty-two out of 116 cases show one of normal endometrial pictures which appear in three phases of menstrual cycle. (4) Dysfunctional uterine bleeding is mostly due to ovarian disorders, but dysfunction of the uterus is also one of the factors. (5) It is impossible to diagnose the dysfunctional uterine bleeding only by endometrial pathology, because there is no uniform picturein cases of experimentally induced withdrawal bleeding. (6) It is important to diagnose the dysfunctional uterine bleeding by not only histopathlogy of endometrium, but also day of cycle that bleeding is started and duration of bleeding. (7) Intermenstrual bleeding does not happen on ovulatory phase, but preovulatory phase and it is difficult to differerenciate from polymenorrhea or dysfunctioal uterine bleeding if it is prolonged. It is supposed that prolonged "intermenstrual bleeding" is originally same as polymenorrhea or dysfunctional uterine bleeding. (8) The term "dysfunctional uterine bleeding" should be used only as "clinical term", and bleeding due to ovarian dysfunction has to be diagnosed by pathophysiology of ovarian level; those are, follicular persistence, anovulatory cycle, inadequate luteal phase and corpns luteum persistence.

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