[Picture and significance of the pre-ovulatory phase of the cycle as understood from the vaginal smear].
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Female↗
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[Practical value of vaginal smear].
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Female↗
[Of what good are the vaginal smears?].
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Female↗
[Diagnostic value of vaginal smears].
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Female↗
Cytolysis and karyopyknosis in postmenopausal vaginal smears as markers of endometrial cancer, diabetes and obesity. Studies based on a ten-year follow-up.
The vaginal cytology of 507 postmenopausal women was followed prospectively for ten years. Of the subjects, the 207 with cytolytic or karyopyknotic vaginal smears constituted the study group and the 300 with atrophic smears (indicating an absence of estrogenic activity) constituted the control group at the beginning of the follow-up. A woman whose initial smear was cytolytic usually had a cytolytic smear ten years later, which implies that high postmenopausal estrogenic activity is constitutional. Both at the beginning of the study and ten years later, the mean body weights were higher in the study group than in the control group. The mean karyopyknotic index and the prevalence of cytolytic smears were significantly higher among women with impaired glucose tolerance than among subjects with a normal glucose tolerance test. During the follow-up period, 3.6% of the women in the study group and 0.7% of the women in the control group developed endometrial cancer (P less than .02). The incidence of 3.6% of endometrial cancer is significantly higher than the corresponding age-specific incidence (P less than .001). We conclude that obese and/or diabetic postmenopausal women with cytolytic or markedly karyopyknotic vaginal smears exhibit a high intrinsic estrogen activity and may thus be at risk for endometrial cancer.
Diabetes Complications↗
Antibiotic spectrum of isolated germs in the vaginal smear of Nigerian women.
The bacteriological research of 534 vaginal smears of pregnant women and patients of the gynaecological ward in Abeokuta showed in 21.6% beta-hem. Streptococcus group D, in 10.9% Staphylococcus epidermidis, in 5.3% Escherichia coli, in 3.6% Staphylococcus aureus, in 1.3% beta-hem. Streptococcus group B and in 7.8% yeasts. 48% of all smears remained sterile. The antibiotics with the least effect were Tetracyclines and Penicillines. Trimethoprim and Sulfonamid, Ticarcillin and Netilmycin were able to prevent the bacterial growth by at least 89%. Isolated germs of private patients showed higher resistance against Tetracycline and Chloramphenicol than those of non-private patients.
Anti-Bacterial Agents↗
[Pollen granules and other plant findings in cervico-vaginal smears].
42 cervico-vaginal out of 20,000 smears were singled out with extraneous structures of vegetable kind. Botanic analysis showed fragments of tracheae, fibres, etc., and mainly many pollen grains. The reports, accompanied by a set of pictures, are showed. Some hypotheses are presented concerning their origin. Some suggestions are proposed in order to reduce this kind of contamination which, mainly because of pollens, may lead to erroneous diagnoses.
Adolescent↗
Association of vaginal smear cytology with menstrual status in breast cancer.
The relationship of clinically defined menstrual categories and an independent measure of hormonal stimulation, maturation index of vaginal smear cytology, was studied. Analysis of 596 smears obtained at the time of breast cancer diagnosis revealed a statistically significant association between menstrual status and maturation index. However, within each menstrual group varying levels of maturation were noted. Estrogenic effect in the absence of exogenous hormone administration was found in 11% of patients following bilateral oophorectomy and among 24% of women whose natural menopause occurred 20 years or longer prior to diagnosis. Endogenous estrogen production appears to continue for many years among some women. Clinical factors such as obesity, diabetes and/or hypertension may stimulate high squamous maturation in some patients. Others of the same age and with similar clinical histories were found to have atrophic smears. The differences in maturation index may be due to individual variations in: endogenous hormone levels; sensitivity of the vaginal mucosa to similar hormonal stimuli; use of certain medications; or unidentified exogenous factors. The maturation index was found to be significantly associated with the following prognostic factors: weight relative to height, tumor size and estrogen receptor content of the primary tumor. These findings indicate that vaginal smear cytology may define specific subsets within menstrual categories which may be relevant to therapy and prognosis in breast cancer.
Adult↗
Cytohormonal evaluation of vaginal smears by phase contrast microscopy with special reference to progesterone deficiency pattern during early pregnancy as predictor of abortion.
Cytohormonal profile of unstained vaginal smears were studied under phase contrast microscope to define various cell morphologies in detail and build up of smear pattern serially in various stages of menstrual cycle and first trimester of pregnancy. The findings were correlated clinically and found comparable to Papanicolaou stained smears. The maturation index was calculated more objectively by phase contract microscopy because of the refractile appearance of the pyknotic nuclei of superficial cells. The prognostication of abortion was done by combining abnormal maturation index and the presence of syncytiotrophoblasts in vaginal smears. Under phase contrast microscope, the sensitivity of abnormal smear was 87.5%, the specificity was 95%, the positive predictive value was 96.55% and the overall accuracy was 90% as compared to positive Papanicolaou smear whose sensitivity though 93%, had low specificity of 50% only. Phase contrast study appears to offer certain distinct advantage over the conventional light microscopy for quick, comprehensive and quantitative assessment of the study material. It allows the physician to detect changes in the material obtained from the patients without detour of laboratory fixation and staining. It is technically easy as errors in interpretation due to unsatisfactory fixation, staining and artefacts are obviated. Thus phase contrast microscopy offers an alternative and easy method of cytohormonal evaluation of wet and unstained smears.
Abortion, Threatened↗
Diagnosis of sexual cycle by means of vaginal smear method in the chinchilla (Chinchilla lanigera).
An investigation was made as to whether the sexual cycle and pregnancy can be determined by means of vaginal smear in chinchillas. This study represents the first attempt to record changes which occur in the pattern of exfoliated cells in chinchilla's vaginal smear during anoestrus, proestrus, oestrus, metoestrus and pregnancy. Fifteen female chinchillas aged from 8 months to 3 years and bred through harem breeding method were used. The major change during proestrus was an increase in the proportion of superficial cells, with a corresponding decrease in other cells. Goblet cells were observed in the smears prepared by strong aspiration during this cycle. Neutrophils, small and large intermediates and parabasal cells were not found in the smear during oestrus and the smear consisted of superficial cells only. In the proportion of neutrophils, small and large intermediates and parabasal cells increased during metoestrus. In addition, metoestrum and foam cells were found in this cycle. In anoestrus; superficial and parabasal cells were present in small numbers. Also small and large intermediate cells as well as neutrophils were present. Traces of foam and metoestrum cells were found. During pregnancy, neutrophils generally of medium density were present, parabasal; small and large intermediate cells were present at low or medium density, and superficial cells were only present in trace amounts.
Animals↗
[Enterococcus faecalis in vaginal smear of women who have been treated with antibiotics].
This investigation had an aim to establish the incidence of Enterococcus faecalis in vaginal smears and its correlation with antibiotics used for the treatment of genital and extragenital diseases, as well. By this prospective study 300 women in reproductive period have been involved. An average age was 34.5 years and 282 of them are married. They have been divided in 4 groups, 75 in every group. First group consisted women who have not been treated by an antibiotic in last 6 months; second group--women who have been treated due to infections of genital tract; third group--women were treated for unspecific colpitis and last one group were women treated for extragenital infections. A special designated questionnaire has been used to collect data from patients. A vaginal smears for microbiology examination has been taken at the Gynecological Clinic and Clinic for Infective diseases of The University Clinical Center Tuzla from patients of group I, II and IV and at the Outpatient Clinic from patients of group III. Enterococcus faecalis has been found in 112 patients (37.33%); in first group in 13 (17.33%) cases, in second group in 26 (34.66%), in third group 39 (52%), and in last group in 34 (45.33%) patients, which significantly different. Investigation on sensitivity showed a minimal sensitivity on Penicillin and Streptomycin and no resistance on Vancomycin. In conclusion, it could be said that Enterococcus faecalis was found in 17.33% patients who has not been treated by antibiotics and in 44% who used antibiotics, which differ significantly (p<0.01).
Adult↗
Goblet-like cells in atrophic vaginal smears and their histologic correlation. Possible confusion with endocervical cells.
The occurrence and origin of goblet-like cells seen between clusters of parabasal cells in atrophic vaginal smears were investigated. The goblet-like cells were cytologically identified in the vaginal smears from 23 (19.2%) of 120 patients whose smears showed an atrophic pattern, but without any inflammatory, dysplastic or malignant changes. Histologically, these cells were found in sections from 6 (18.8%) of 32 elderly women with atrophic vaginal epithelium. The goblet-like cells were situated among the squamous cells of the upper layer of the atrophic squamous epithelium from the vagina to the portio. These goblet-like cells in atrophic smears were initially misinterpreted as endocervical cells, which are regarded as a marker of smear adequacy in the cytologic screening for cancer of the uterine cervix. The correct interpretation of these goblet-like cells in smears from postmenopausal and elderly women is thus obviously important in assessing the adequacy of the sample for the detection of abnormal cells.
Adult↗
[Changes in immunoglobulin-positive cell populations in the vaginal smear during radiotherapy of cervical cancer and their relation to 5-year survival rate].
To study the immunological response of irradiated cervical cancer, vaginal smears were taken from patients with this neoplasm during radiotherapy and stained with fluorescent anti-Igs sera by a direct method. Then, the relationship between the immune response during radiotherapy and a five year cure were discussed. The results obtained were as follows: 1. The mean percentage of the surface IgM-positive cells was 1.9% in normal vaginal smears and 5.8% in cervical cancer. 2. On the changes in the surface IgM-positive cells during radiotherapy, the patients were classified into three groups. Group A: The number of surface IgM-positive cells increased temporarily during radiotherapy. Group B: The number of surface IgM-positive cells decreased gradually during radiotherapy. Group C: The changes in the surface IgM-positive cells were irregular and/or showed little deviation. The five year survival rate for Group A was 81.8% and for Group B was 50.0%. There was significant difference between Group A and Group B in survival rates, and Group A was considered to be an immunoreactive group.
Female↗
Cyanophilic bodies in cervico-vaginal smears.
Thirty-six out of 171 (21%) cervico-vaginal smears that manifested pronounced squamous epithelial atrophy contained cyanophilic bodies about the size and shape of parabasal cells. These cyanophilic bodies have been misinterpreted as cancer cells. Patients whose smears contained cyanophilic bodies were likely to be elderly, at least ten years postmenopausal, and free of any gynecologic symptoms or abnormalities except those associated with previous surgery. Smears which contained cyanophilic bodies also contained numerous parabasal cells in various stages of degeneration, objects which closely resembled trichomonads, and a heavy background of granular material. A morphologic continuum existed between all of these elements. The conclusion, therefore, is that cyanophilic bodies, spurious trichomonads and the granular material are all derived from degenerating parabasal cells. It is suggested that cyanophilic bodies develop because of the diminished efflux of exfoliated epithelial cells and mucus associated with squamous epithelial atrophy. The ensuing stagnation of parabasal cells allows them to degenerate to an advanced degree. It appears that as some of the parabasal cells degenerative, their nuclear chromatin becomes widely dispersed throughout the cytoplasm, thereby forming cyanophilic bodies.
Cervix Uteri↗
An international study of the interobserver variation between interpretations of vaginal smear criteria of bacterial vaginosis.
An international workshop on vaginal smear-based diagnosis of bacterial vaginosis was organized where 13 investigators scoring 258 slides with smears from vaginal fluid. Interobserver reproducibility of interpretations of Nugent scores, Hay/Ison scores and wet smear scores for the diagnosis of bacterial vaginosis was shown to be high. Detailed analysis of individual scoring results however indicated that basic standards of quality control to ensure robust individual readings of slides must be adhered to.
Bacteriological Techniques↗