[New technic for the differential staining of vaginal smears; vaginal cytology].
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Coloring Agents↗
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Results for “VAGINAL SMEARS”
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Postoperative changes in vaginal smears after vaginal reconstruction with a free skin graft.
Surgical vaginal reconstruction was performed by a free skin graft in two patients without a vagina. The postoperative changes in vaginal smears collected from the artificial vaginas were observed for about two years. Marked operation-induced inflammatory changes were observed until the second postoperative month. After the third postoperative month, the background became relatively clear. Cyanophilic and eosinophilic superficial cells, intermediate cells and Döderlein bacilli were observed occasionally in addition to keratotic cells. Six to 12 months after surgery, the vaginal smears showed little abnormality, except for the presence of keratotic cells. The changes in the vaginal smears after the third month show that the artificial vaginal epithelium changed cytologically to an almost normal vaginal mucosa that, although not histologically complete, responded to hormones. The presence of Döderlein bacilli suggests that the regional environment of the artificial vagina was almost the same as that of the normal vagina.
Adolescent↗
[A quick and inexpensive staining method for vaginal smears].
Vaginal cytology is a commonly used method for diagnosis of sexual cycle phases in the rat, but all staining techniques are time consuming. A simple, easy and fast technique is reported here, that is based upon the use of a Lugol solution that allows precise identification of the sexual cycle day of the rat. Following this technique, samples are taken at 8:00 a.m. and a smear is made on the glass slide adding one drop of Lugol solution. This preparation is covered and seen directly under the optic microscope.
Animals↗
Detection of ovulation by vaginal smears; a comparative serial study of vaginal smear endometrial biopsy and urinary pregnanediol.
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Body Fluids↗
A comparison of the use of Papanicolaou-stained cervical cytological smears with Gram-stained vaginal smears for the diagnosis of bacterial vaginosis in early pregnancy.
Our objective is to compare the efficacy of using Papanicolaou (PAP)-stained cervical cytology smears with a standardized method of interpreting Gram-stained vaginal smears for the diagnosis of bacterial vaginosis (BV) in pregnancy. High vaginal smears were Gram-stained and examined by a single observer to characterize 3 grades of vaginal flora and diagnose BV. Cervical smears were PAP-stained and examined for characteristic patterns of vaginal flora including evidence of BV by either a number of cytotechnicians or a single cytopathologist. The results of the 2 methods were compared. Seven hundred and forty-seven women attending an antenatal clinic in a district general hospital who consented to have a smear of vaginal secretions and cervical cytology in early pregnancy. The main outcome measure is the diagnosis of BV by different methods in a pregnant population. Compared with the Gram-stain method for the diagnosis of BV, there was good agreement between PAP-stain interpretation by a single observer but the agreement was not as good with PAP-stain interpretation by multiple cytotechnicians. When the grades were consolidated to normal (grade I) and abnormal flora (grades II and III), compared to Gram-stained smears, PAP cytology undertaken by several cytotechnicians had a sensitivity of 80.7% and a specificity of 90.7%. The sensitivity and specificity increased to 87% and 97%, respectively, when the PAP-stained smears were read by a single cytopathologist. Using kappa scores, only those readings made by a single cytopathologist were reliable. The setting in a cytopathology laboratory comprises multiple cytotechnicians, so that PAP-stain analysis of vaginal smears for the diagnosis of BV is likely to provide results which are less reliable than those obtained by Gram staining. The latter should be the first choice and every effort should be made to set up this service.
Cervix Uteri↗
The use of sequential self-obtained vaginal smears for detecting changes in the vaginal flora.
BACKGROUND AND OBJECTIVES: The ability to study daily changes in the vaginal flora may provide insight into the pathogenesis of bacterial vaginosis. Because culture of the vaginal fluid is tedious and expensive, the utility of self-obtained vaginal smears for documenting changes in the flora was evaluated. GOALS: To validate the adequacy of self-collected vaginal fluid Gram stains and use them to monitor vaginal flora. STUDY DESIGN: Ten asymptomatic premenopausal women collected daily vaginal smears for 30 days. The smears were Gram stained and interpreted using a standardized scoring system (Nugent criteria). In addition, results from self- and clinician-obtained vaginal smears from 18 women were compared to validate the adequacy of self-obtained smears. RESULTS: Two women had asymptomatic bacterial vaginosis. One woman, who was postpartum, had intermediate flora that toward the end of the collection period changed to Lactobacillus predominant. The remaining seven women exhibited two patterns. One was Lactobacillus morphotypes only; the second consisted of Lactobacillus-predominant days interspersed with days with moderate to high numbers of Gardnerella/Bacteroides morphotypes. There was a significant correlation of the point of change in the flora of this group with menses. CONCLUSIONS: The adequacy of self-collected vaginal fluid Gram's stains was validated. Changes in vaginal flora were demonstrated over a 30-day period by use of this methodology.
Female↗
Post-menopausal smear patterns--a review of vaginal smears in 480 women.
Cytohormonal evaluation was done on the vaginal smears of 480 normal, asymptomatic, post-menopausal women whose ages ranged from 36 to 74 years. About 50% showed atrophic smears consistent with total oestrogen lack. 41% had mild to moderately proliferative smears compatible with sub-optimal oestrogen stimulus. 9% showed a highly proliferative pattern typical of unopposed oestrogen effect and in this group two women had atypical endometrial cells in their smears, which subsequently were found to come from an atypical endometrial hyperplasia and an endometrial adenocarcinoma-in-situ. The clinical relevance of cytohormonal studies in post-menopausal women is briefly discussed.
Adult↗
[The introduction into France of cervical-vaginal smears].
Cervico-vaginal smears were quite difficult to accept when they were at first introduced in France, during the fifties, probably due to fear that cytology might replace surgical pathology, where as both methods may develop close together. At last, bridging the gap was accomplished by the pathologists and, nowadays, many cytopathologists have been trained and became quite clever. Obviously, clinicians cannot do without the method described by George N. Papanicolaou (the so-called Pap test). Although cervical carcinoma is the very one cancer that should have been eradicated, as complete recovery is the rule when the diagnosis is made in time, at the preinvasive state of the tumor, in France it is still responsible for 2000 annual deaths. Systematical target pollution screening should be organized, as well as in other countries and should become one of the main priorities into health care control
Female↗
Nuclear inclusion bodies in vaginal smears from patients with vaginal discharge.
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Adult↗
[Vaginal smear after cure of trichomonas vaginitis].
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Female↗
Columnar cells in posthysterectomy vaginal smears.
Columnar cells in posthysterectomy vaginal smears are unusual and rare. Nine such cases are reported here during a 6-yr period. All nine patients were asymptomatic and total hysterectomy with bilateral salpingoophorectomy for gynecological malignancies was performed 8 mo to 25 yr ago. Three patients had local radiation and one had systemic chemotherapy not less than 8 mo before the cytology. The columnar cells showed one of three patterns: 1) long, bipolar cells in sheets, resembling reparative columnar cells (4 cases), 2) goblet-type cells with eccentric nuclei (3 cases), and 3) tight clusters of small round cells (2 cases). No consistent relationship with age, treatment, or background was seen with any of the patterns. Follow-up of all cases by thorough pelvic examination, repeat smears, colposcopy, and biopsy showed no vaginal pathology. Benign mucinous or goblet cell metaplasia in atrophic vaginal epithelium may be the source of some of these cells in the vaginal smears.
Adult↗
[Detection of bacterial vaginosis in gram stained vaginal smears and papanicolaou stained cervical smears].
OBJECTIVE: To determine the sensitivity and specificity of diagnosis of bacterial vaginosis (BV) by papanicolaou (PAP)-stained cervical smears and gram-stained vaginal smears according to clinical criteria. METHODS: In the prospective study of 196 non-pregnant women of child-bearing age, 94 were clinically diagnosed to have BV. Gram-stained vaginal smears and PAP-stained cervical smears were collected from all enrolled patients. RESULTS: In comparison with clinical diagnosis of BV, the sensitivity and specificity of gram-stained vaginal smears and PAP-stained cervical smears were 94.7% (89/94), 98.0% (100/102) 85.1% (80/94), and 95.1% (97/102). The characteristics of BV in gram-stained vaginal smears and PAP-stained cervical smears included small bacteria of Gardnerella and bacteroides morphotypes and curved gram variable rods and absence of bacteria of Lactobacillus morphotypes. CONCLUSION: It is possible to screen and manage BV according to Gram-stained vaginal smears or PAP-stained cervical smears.
Adult↗
Telecytology: intraobserver and interobserver reproducibility in the diagnosis of cervical-vaginal smears.
Telecytologic diagnosis of cervical-vaginal smears is potentially useful because it could allow more efficient use of cytopathologist resources and expertise. A pathologist in one location could, in principle, review cytotechnologists' findings using a video display hundreds or thousands of miles away. Currently, bandwidth restrictions limit practical implementation of such a system to review of fields that had been selected for review by the cytotechnologist. The purpose of our investigation was to evaluate how well this type of review correlates with a review in which the entire slide is available for examination by the pathologist. We prospectively selected 100 consecutive cervical-vaginal smears over an 11-day period in August 1999. For each smear, 4 to 12 fields containing abnormal cells from each slide were digitally imaged. Each of 3 pathologists reviewed all digitized images and all glass slides. Diagnoses based on selected digitized images were compared with those based on conventional pathologist review. The kappa statistic, a measure of chance-corrected agreement (reproducibility), was calculated in each setting. Overall, intraobserver and interobserver reproducibility of cervical-vaginal smear diagnoses is fair to excellent. The use of remote digital images for pathologist review did not introduce large (2-step) diagnostic disagreements. The disagreement between a pathologist's glass slide and digital diagnoses is less than that for different pathologists reviewing glass slides, although interobserver differences were even greater in the interpretation of digital images.
Cytodiagnosis↗
Artificial intelligence in automated classification of rat vaginal smear cells.
Microscopic examination of vaginal smears has been used routinely to determine the stage of the estrous cycle of female rats in reproductive research. The stage of the estrous cycle is based on relative counts of nucleated epithelial cells, cornified epithelial cells and leukocytes. The purpose of this project was to explore automation of vaginal smear analysis using image processing and artificial intelligence techniques. A fully connected back-propagation neural network was used to locate all potential objects in a digitized scene. A unique algorithm was then employed to center a subsequent sampling box to collect pixel intensity values from the red and green components of each image. A final neural network was used in the classification of cell type. Neural networks were used because of their ability to generalize among input patterns and to tolerate extraneous noise due to variations in staining artifacts and aberrant illumination of the microscope field. This preliminary cell diagnosing system not only provides the basis for the fully automated system but also provides a method by which many other cytologic image processing problems can be automated.
Animals↗
Toxoplasma cysts in vaginal smears.
Toxoplasma cysts in vaginal smears in women have been found. Exact identification of these cysts is of the greatest importance in order to avoid false positive diagnosis for cancer. From the epidemiological point of view, this finding supports the theory of transmission from cysts located in the female genital tract.
Complement Fixation Tests↗
Telecytology: diagnostic accuracy in cervical-vaginal smears.
Although cervical-vaginal telecytology is a promising tool, diagnostic accuracy has not been extensively evaluated. The authors examined the accuracy of five cytotechnologists who retrospectively reviewed 50 cervical-vaginal smears using the video monitor, and 2 months later, using the light microscope. Accuracy was expressed in terms of crude agreement with the original diagnosis and number of false positives (FPs) and false negatives (FNs). With a greater than one step difference as discrepant, the group crude agreement using the video monitor and the light microscope was 85.6% and 95.6%, respectively. The group number of FNs and FPs for the light microscope was 8 and 7, respectively, and for the video monitor was 34 and 7, respectively. There was a wide range of individual performance. We conclude that accuracy of telecytology is high, but less than that of light microscopy. The major reason for lower telecytologic accuracy was undercalling dysplasia.
Cytodiagnosis↗
Effects of ovarian steroids on vaginal smears in the rat.
A correspondence between the appearance of vaginal smears and the layers of the epithelium from which the cells had desquamated was established in untreated rats during the estrous cycle, in control ovariectomized rats and in spayed rats injected with either estrogen or progesterone. The technique for preparing and staining the smears (modified Shorr's staining procedure) is outlined. A simplified system of classification which allows the accurate identification of the various stages of the reproductive state in the rat is described. Standing estrus, as well as the influence of estrogen on spayed rats, is characterized by marked cornification of the cells and the disappearance of leukocytes. At the end of estrus, the cornified layer is sloughed off and invasion by leukocytes occurs. During diestrus, as well as in untreated ovariectomized rats, the vaginal contents consistently lack cornified cells whereas leukocytes are very plentiful. Proestrus follows diestrus: the vaginal smear is devoid of leukocytes and characterized by nucleated epithelial cells. Pregnancy, as well as the influence of progesterone on ovariectomized rats, is also characterized by epithelial growth and desquamation but at different rates, resulting in the presence of intermediate cells, and polymorphs and mucus forming a noticeable background to the smear. Since vaginal smears display cell pictures characteristic for each hormone after administration of estrogen or progesterone, exfoliate cytology is a good indicator of the stage of the reproductive state in the rat.
Animals↗
[Vaginal smears of malignant ovarian tumors: comparison with cervical canal, aspirate uterine corpus, ascites, imprint smears and cytomorphology of histological specimens (author's transl)].
Vaginal smears of 21 patients with malignant ovarian tumors were examined. In 5 cases malignant cells were present: 1 mucinous cystadenocarcinoma, 2 poorly differentiated adenocarcinomas, 1 clear cell carcinoma, and 1 adenoid squamous cell carcinoma arising in a dermoid cyst. Cytomorphology of tumor cells in tissue specimens and imprint, ascites, aspirate uterine corpus, cervical canal and vaginal smears were examined. The ovarian malignant cells of the vaginal smears were grouped, round or oval with eccentric round or oval nuclei having a finely granular chromatin pattern regularly distributed, and with vesicular or vacuolated cytoplasm. Tumor diathesis appeared in 1 of 5 cases. Two post-menopausal patients showed an increase of superficial cells in the maturation index. In the comparison of malignant cells taken from different locations, vaginal tumor cells were similar to those in ascites. Since ascites smears were reported to be useful for the diagnosis of some kinds of ovarian tumors, it was expected that vaginal smears might also have this potentiality.
Adult↗