The political reality of underwriting issues.
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Biomedical subjects
Publications and source records attributed to D C Chambers.
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Trichomonas vaginalis infection (TVI) was found by examination of Pap smears in 25% of 3,005 unselected urban black women being screened for cancer of the cervix and vagina. The incidence was 22% in the group under 29 years of age; 69% in those between 30 and 59; and 9% in those over 60. Women who had had a hysterectomy had 16% lower incidence of TVI than did the controls. Class 1 reports (atypia, metaplasia, hyperplasia) were obtained in 10% of the entire group. Cytologic changes were present in 19% of the women with TVI. Women who had had hysterectomy had a 40% less chance of having a class 1 report compared with controls. Class 1 reports occurred 2.7 times more frequently in TVI than in uninfected controls.
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The questions of whether a Pap test should be done in patients who have undergone hysterectomy for benign uterine disease and, if so, how often were addressed by reviewing the records of 3,008 black women seen in a cancer screening clinic. No vaginal carcinoma was found in the posthysterectomy patients or in the control group with the uterus in place. The absence of carcinoma in the posthysterectomy group suggests that although an annual physical examination is indicated, the time interval between performance of the Pap test may be lengthened.
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Results of 3,009 Papanicolaou smears from black women are reviewed. The modus operandi and cost for the outpatient component are presented. Abnormal results were reported in 11.6 percent of the combined outpatients and inpatients. The major portion of the changes in this subset were due to atypia present in a substantial number of women with Trichomonas vaginalis vaginitis. Programs of this nature with a specific objective may be easily merged into the basic medical services provided by an outpatient and inpatient department.
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Electrophoretic fractionation of lactate dehydrogenase in amnionic fluid was utilized to demonstrate the five isoenzymes usually found in a variety of human tissues. The anaerobic portion of the isoenzyme spectrum was prominent, and the percentage distribution may be related to the metabolic activities of tissues contributing to the formation of the fluid. In contrast to the placenta, an "extra" isoenzyme was not found in the fluid.
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The granular cell myoblastoma (granular cell tumor) is a rare lesion of mesodermal origin that occurs in many areas of the body, including the vulva in seven percent of cases. The exact origin of this tumor is still being investigated. However, nerve cell origin is generally accepted. Lesions of the vulva occur in any age group and must be biopsied to rule out carcinoma, hidradenomas, sebaceous cysts, and papillomas. The recurrence rate of incompletely excised lesions is 25 percent. The microscopic picture of the lesion may simulate carcinoma as a result of reactive hyperplasia of the overlying epidermis. Discovery of a mass on the vulva in any patient which on biopsy reveals a granular cell myoblastoma should lead the examiner to excise the lesion completely and also to search for other lesions at various sites of the body.
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