Examination Of Vaginal Smears Research Articles

Cancer of uterine cervix in Indian women. Results of the population screening program.

There is no invasive cancer which at one stage was not cancer-in-situ. The cervical cancer if detected at its pre-invasive stage is amenable to treatment with 100% survival rate. The knowledge that cancer is preventable if detected in its precancerous stage or is curable if detected in its early stage strongly supports the need for routine cytological examination of all young females from time to time for detection of cervical neoplastic lesion in its early stage and a follow-up of all the dysplastic lesions of cervix. Present study comprises of an examination of vaginal smears of 39,587 women aged 14 to 80 years. Malignancy of female genital tract was observed in 693 cases. On cytological and histological examination the cancer of the cervix was diagnosed in 64 clinically unsuspected cases giving a pick up rate of 1.62/1000. In each of these cases the initial clinical impression of the cervix was other than carcinoma, the first indication of malignancy being the result of cytological examination. Cervical dysplasia was detected in 927 cases. A follow-up study of progression or regression of dysplastic changes was done.

Effect of Removal or Stimulation of the Olfactory Bulbs on the Estrous Cycle of the Guinea Pig

The effect of removal of the olfactory bulbs on the estrous cycle of the guinea pig was followed by daily examination of vaginal smears. Sham-operated and normal animals were also studied. The estrous cycle was not altered by this operation but anosmic females mated less readily than controls. Daily electrical stimulation of the olfactory bulbs throughout one or more estrous cycles failed to disturb the rhythm and it is concluded that the sense of smell is of little importance in the control of gonadal activity in the female guinea pig. However, olfactory stimuli may be of significance in the manifestation of estrous behavior. (Endocrinology77: 213, 1965)

Report of Cytological Examination of Vaginal Smear in our Clinic

Report of Cytological Examination of Vaginal Smear in our Clinic

KLINISCH-EXPERIMENTELLE STUDIEN MIT MENSCHLICHEM HYPOPHYSÄREM GONADOTROPIN

ABSTRACT Gonadotrophin extracted from human hypophyses (HHG) was administered in clinical trials to 5 amenorrhoic women. Gonadotrophin levels in the blood and urine and the urinary excretion of oestrogen, pregnanediol, 17-hydroxycorticosteroids, 17-ketosteroids and pregnanetriol were determined before, during and after treatment. Clinical control methods included endometrial biopsy and vaginal smear examination. Following the i. m. administration of HHG the gonadotrophin excretion increased markedly within the first 24 hours. Plasma gonadotrophin increased to substantially higher levels within 4–6 hours after the first injection. After cessation of treatment both plasma and urine gonadotrophin concentration returned slowly within 2–4 days to the pre-treatment levels. Following treatment, all 4 patients with hypogonadotrophic amenorrhoea (primary pituitary insufficiency) responded by an increased oestrogen and pregnanediol production. It would seem therefore that HHG-treatment had succeeded in producing ovulation. The single case of hypergonadotrophic amenorrhoea (primary ovarian insufficiency) showed no response in this respect. No change in 17-OHCS excretion was effected by the HHG-treatment. Changes in 17-ketosteroids and pregnanetriol excretion did not show a constant pattern. The clinical effects obtained in the 4 hypogonadotrophic amenorrhoea cases are confirmed in that ovulation was induced by means of the treatment.

HISTOCHEMICAL LOCALIZATION OF FOUR DEHYDROGENASE SYSTEMS IN HUMAN OVARY DURING THE MENSTRUAL CYCLE

ABSTRACT The histochemical localization of four dehydrogenase systems (diphosphopyridine nucleotide diaphorase, lactic, succinic and steroid-3β-ol-dehydrogenase) has been studied in human ovary during the menstrual cycle. The phase of the cycle was determined using endometrial biopsy and vaginal smear examination and by estimations of the urinary excretion of pregnanediol-complex. All the dehydrogenases were found to exhibit equal distribution; the most active structures were the theca interna cells of the developing follicles and both thecal and granulosa lutein cells of the corpora lutea. Atretic follicles as well as corpora albicans consistently showed moderate dehydrogenase activity. Formazan deposit was always developed in the interstitial cells of the stroma. No changes were detected in the enzyme activity during the follicular and progestational phases of the cycle.

A single differential staining method for vaginal samears

Since the observation of STOCKARD and PAPANIKOLAOU (1917) on the cyclic cytological changes of vaginal smears in guineapigs in accordance with their estrous cycle, many morphological studies have been made on vaginal smears of different mammals by many investigators. Recently, the examination of vaginal smears has come to be significant not only in the determination of each stage of the estrous cycle and in sexual hormone tests, but also in the clinical use. As for the staining of vaginal smears, there are many methods using such a single stain as methylene blue and Giemsa stain or such a compound stain as Masson's trichrome and Heidenhain's azan stain. Especially, SHORR (1940a, 1940b, 1941), PAPANIKOLAOU (1942), and CuYLER (1932) have reported a single differential staining method which is generally used for vaginal smears. The principle of this method of staining consits in the demonstration of changes in stainability of epithelial cells by using a staining solution composed of some acidic dyes. For instance, orange G, scarlet red, and fast green are used in Shorr's method, by which cornified cells are stained blilliant orange-red and non-cornified cells blue. By Papanikolaou's method, in which light green, Bismarck brown, and eosin Y are used, acidophilic cells are stained red to orange and basophilic cells green or greenish blue.

UTERINE MYOMA. SOME HORMONE ASSAYS

In 46 myoma cases, preoperative determination of oestrogens in the urine was carried out by a biological method, a cytological determination being employed in the examination of vaginal smears. At the same time, the total quantities of F. S. H., pregnandiol and 17-ketosteroid were determined. Histological specimens obtained at operation were compared with the results of the hormone determinations. The material was divided into two age groups, patients under 45 years old (group I) and those of 45 or over (group II). The average amount of oestrogen in the urine in group 1 was 820 IU per day and in group II 573 IU per day. In group I, analysis revealed hyperoestrogenism (E 1000 IU or more) in 10 out of 28 cases, while cytologically the condition was observed in 10 out of 24 cases. The corresponding figures for group II were 6/18 and 4/12. Despite high oestrogen values, good corpus luteum activity was often observed in group I. This was a rarer occurrence in group II, in which hyperplasia of the endometrium was more common. It therefore seems probable that in the genesis of myoma, absolutely increased oestrogen secretion plays a fundamental role independently of ovulation. It was observed that in hyperoestrogenism the corpus luteum mostly induced secretory activity in the uterine mucosa while in the vaginal cells a high oestrogen reaction was preserved which indicated an absolute increase in the oestrogen secretion. The endometrium may thus be considered a more sensitive indicator of progesterone than the vaginal cells. In one case an active corpus luteum with normal secretion was observed without any simultaneous secretory activity in the endometrium. In most of the cases the secretion of F. S. H. into the urine was within normal limits. Despite a high oestrogen secretion, there was a hypersecretion of F. S. H. into the urine in 3 cases. The hyperoestrogenism is thus considered to be of pituitary origin.

The clinical evaluation of 2-acetylamino-5-nitro-thiazole, an orally effective trichomonacide

Routine examination of vaginal smears by the culture method of Kupferberg, Johnson, and Sprince showed that 31.6 per cent of gynecologic clinic patients harbored Trichomonas vaginalis. Twenty per cent of pregnant patients were found to be infected when the same diagnostic technique was used. About 60 per cent of these patients had symptoms attributable to the disease.A potent trichomonacidal agent, 2-acetylamino-5-nitrothiazole, was shown to be effective when administered orally. The parasites were eradicated in 35 per cent of infected patients regardless of the presence or absence of symptoms when the drug was administered in a daily dose of 300 mg. as enteric-coated tablets for a period of seven to ten days. With dosages exceeding 450 mg. per day, side reactions such as anorexia, abdominal cramps, nausea, and dark discoloration of the urine became pronounced without a corresponding rise in the parasitologic cure rate. There was no demonstrable change in the hemograms of these patients during and after therapy.Evidence has been presented that T. vaginalis can be cradicated by the systemic action of a new trichomonacidal agent.

DETERMINATION OF GENETIC SEX BY THE VAGINAL SMEAR

Much interest has been devoted lately to the determination of genetic sex by studying the cell nuclei in skin biopsy specimens. This has proved a very useful clinical procedure in cases of hermaphrodism and “ovarian agenesis” (1–5). During the routine examination of vaginal smears stained by the Papanicolaou technique, it was observed by us that in many instances the sex chromatin could be distinguished remarkably well in the nuclei of the vaginal epithelial cells, especially if these were clear and vesicular and showed a finely granular chromatin meshwork.

Comparative and statistical study of vaginal and urinary sediment smears.

IN GYNECOLOGIC and endocrine practice, the examination of vaginal smears furnishes valuable information about the functional state of the ovaries, with regard to both trophic and cyclic activity. In the year 1946, del Castillo, Argonz and Galli Mainini (1) proposed, for the same purpose, a new method capable of substituting in certain cases for the vaginal smear and based upon assays with the urinary sediment. These authors observed that the examination of urinary sediment cells, repeated in different stages of the sexual cycle, showed characteristic variations which, when the smears were made in the same manner, exhibited a “close parallelism” with the variations in the cells of the vaginal mucosa. When estrogen was administered to patients, either castrated or with the syndrome of rudimentary ovaries, identical modifications could be observed with the two methods.

Un Cas de Nanisme Avec Insuffisance Ovarienne Totale et Hypersécrétion D’Hormone Gonadotrope

SummaryTypical case of Turner’s syndrom is reported. Diagnosis is based on the following signs :1° dwarfism ;2° ovarial agenesia ;3° congenital abnormalities and specially a webbed neck.1° Dwarfism is harmonious ; it seems that prepuberty growth has been delayed. Lightly delayed bone development is shown by XRay study. Neither starvation, nor a definite disease of the bones, nor thyroid, nor pituitary disturbances account for dwarfism. Two other possible factors are suggested : either congenital abnormalities of the epiphyseal cartilage or lack of œstrogenic factor.2° Examination of vaginal smears reveals a picture in agreement with the diagnosis of ovarial agenesia. Hypopituitarism is ruled out by an increased urinary excretion of folliculin secreting hormone : a fact that may be given as a necessary feature of the disease.3° Other abnormalities observed in this case are : webbed neck, epicanthus, nœvi and supernumerary teeth.Oestrogens given by mouth resulted in increased feminisation of the patient features.