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84 NORTH CAROLINA MEDICAL JOURNAL February, 1952 cells are fairly good indicators of the estrogen titer but poor indicators of progesterone or androgenic activity; while the vaginal cells, of course, show all three. In the male urine, the urethral cells will pick up the Lugol solution, giving a fair index of estrogen in the body. This is of special interest in regard to those patients who are taking stilbestrol, and to obese men with large breasts. Precaution I would like to warn against the use of this stain, or any other stain, on the basis of a single vaginal smear, without a full consideration of available history and physical findings. I would recommend that analysis of the vaginal smear, like any other single diagnostic procedure, be considered as a building-block to be fitted in with other blocks, in corroboration of all other associated findings, to form a diagnosis. Also, as in other laboratory procedures, the more smears that are examined, the more nearly correct will be their interpretation. The vaginal smear itself is not infallible; no staining method yet devised is infallible. This stain, perhaps, is less reliable than others in certain conditions, but it will give vital information and make such information immediately available to all who will spare a few minutes daily. Summary and Conclusion The vaginal smear has been found to be useful in the diagnosis of many hormonal conditions in the female. It is easily obtained, ancl may even be made by the patient herself 011 several days and the series carried or sent to the physician later. These smears mirror the hormonal activity in the normal cycle and reveal aberrations in the abnormal. Menopausal smears are the most easily studied, since the immediate cell changes are evident as soon as estrogenic therapy is begun, and since there are no other complicating hormones to change the picture every few days, such as are found while the ovaries are still functioning. Several good stains have been developed, opening up a new field in gynecology, but they require much time and knowledge of cytology. This modification is not offered to replace any other stain or method of staining but to make available to the gynecologist a method of staining whereby he, too, can use the knowledge that has been derived by others in their study of the more complicated stains. The procedure is so simple as to be available to all, yet yields enough detail to serve the most exacting, while obviating the time lag of all the other techniques. References 1. Stoekarrl, C. R., and Papanicolaou, G. N.: The Existence of a Typical Oestrous Cycle in the Guinea Pi?, with a Study of its Histological and Psychological Changes, Am. J. Anat. 22:225-283, 1917. 2. Allen, E., and Doisy, E. A.: Ovarian Hormones; Preliminary Report on its Localization. Extraction and Partial Purification, and Action in Test Animals, J.A.M.A. 81:819-821 (Sept. 8) 1923. 3. Dierks, K.: Experimentelle Untersuchungen an menschlich-er Vaginalschleimhaut. Arch. f. Gynak. 138:111-130; abstr., 137:1024-1026, 1929. 4. Papanicolaou, G. N.: Sexual Cycle in Human Female as Revealed by Vaginal Smears', Am. J. Anat. 52:519-637 (May) 1933. 5. Papanicolaou, G. N., and Shorr, E.: Action of Ovarian Follicular Hormone in Menopause, as Indicated by Vaginal Smears, Am. J. Obst. & Gynec. 31:800-831 (May) 1936 6. Geist, S. H., and Salmon, U. J.: Evaluation of Human Vaginal Smear in Relationship to Histology of Vaginal Mucosa, Am. J. Obst. & Gynec. 38:392-399 (Sept.) 1939. 7. Van Dyke, H. Ii., and Ch'en, G.: Observations on Biochemistry of Genital Tract of Female Macaque, Particularly During Menstrual Cycle, Am. J. Anat. 58:473-199 (March) 1936. 8. Zondek, B., and Stein, L.: Glycogen Content of Human Uterine Mucosa Glycopenia Uteri, J. Endocrinol. 27:395-399 (Sept.) 1940. 9. Randall, L. M., and Power, M. H.: Amounts of Glycogen in Endometrium, Proc. Staff Meet., Mayo Clin. 17:i58-l60 (March 11) 1942. 10. Spyker, M. A., and Fidler, R. S.: Glycogen Studies on Human Endometrium; Correlation of Quantitative Estimation and Qualitative Demonstration by Histological Methods, J. Clin. Endocrinol. 2:365-368 (June) 1942. 11. Papanicolaou, G. N.: New Procedure for Staining Vaginal Smears, Science 95:438-439 (April 24) 1942. 12. (a) Shorr, E.: New Technique for Staining Vaginal Smears, Science 91:321 (March 29); 579 (June 14) 1940; (b) New Technique for Staining Vaginal Smears, Single Differential Stain, Science 94:545-546 (Dec. 5) 1941. 13. Shorr, E.: Evaluation of Clinical Applications' of Vaginal Smear Method, J. Mt. Sinai Hosp. 12:667-688 (Mav-June) 1945. 14. Editorial comment, Obst. & Gynec. Sur. 1:373, 1946. 15. Greenblatt, R. B.: Personal1 communication. 16. (a) Mack, H. C.: New and Rapid Method of Staining Smears Based Upon Specific Color Reaction for Glycogen, Harper Hosp. Bull. 1:54-56 (Jan.) 1942; (b) Mack, C. H.. and Ale, T.: Appraisal of Estrogenic Activity by Vaginal Glycogen Index; Comparison of Oral and Parenteral Estrone, J. Clin. Endocrinol, 2:361-364 (June) 1942; (c) Mack. H. C.: Glycogen Index in Menopause: Study of Certain Estrogen Functions Based on a New Vaginal Smear, Am. J. Obst. & Gynec. 45:402-419 (March) 1943. 17. Nieburgs, H. E., and Greenblatt, R. B.: Specific Estrogenic and Androgenic Smears in Relation to the Fetal Sex During Pregnancy, Am. J. Obst. & Gynec. 57:356-363 (Feb.) 1949. 18. Greenblatt, R. B., Torpin, R., and Brown, W. R.: Diethyl-stibestrol; Clinical Evaluation of Various Modes of Administration. South. M. J. 33:1276-1285 (Dec.) 1940. 19. Greenblatt, R. B.: Vaginal Smear as a Guide to Estra genie Therapy, J.M.A. Georgia 30:297-303 (July) 1941. 20. Bonime, R. G.: Application of Vaginal Smear to Diagnosis of Pregnancy; Preliminary Report, Am. J. Obst. & Gynec. 58:524-531 (Sept.) 1949. 21. Papanicolaou, G. N.: Diagnosis of Pregnancy by Cytologic Criteria in Catheterized Urine. Proc. Soc. Exper. Biol. & Med. 67:247-249 (Feb.) 1948. 22. Nieburgs, H. E., and Greenblatt, R. B.: Significance of Specific Estrogenic, Progestogenic and Androgenic Smears in Menstrual Disorders' and in Pregnancy, South. M. J. 41:972-980 (Nov ) 1948. 23. Nieburgs, H. E.: Gestational Changes in Vaginal Epithelium and Their Relations to Sex of Foetus, J. Obst. & Gyn-aec. Brit. Emp. 54:653-656 (Oct.) 1947. 24. Hall, G. V.: Vaginal Cornification Phases During Pregnancy; Their Prognostic Significance, J. Clin. Endocrinol. 5:34-37 (Jan.) 1945. 25. Benson. II. C., and Traut, H. C.: The Vaginal Smear as a Diagnostic and Prognostic Aid in Abortion, J. Clin. Endocrinol. 10:675-686 (July) 1950. 26. Schuman, W.: Possible Significance of Vaginal Smears in the Diagnosis of Certain Disturbances of Pregnancy, Am. J. Obst. & Gynec. 47:808-816 (June) 1944.
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1952 |
Identifier | NCHH-17-013 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 13 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-013.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-013 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | keep |
Description
Fixed Title * | Page 84 (image) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1952 |
Identifier | NCHH-17-013-0092 |
Form General | Periodicals |
Page Type | all; all images; diagram; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolina131952medi_0092.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 13 |
Issue Number | 2 |
Page Number | 84 |
Health Discipline | Medicine |
Full Text | 84 NORTH CAROLINA MEDICAL JOURNAL February, 1952 cells are fairly good indicators of the estrogen titer but poor indicators of progesterone or androgenic activity; while the vaginal cells, of course, show all three. In the male urine, the urethral cells will pick up the Lugol solution, giving a fair index of estrogen in the body. This is of special interest in regard to those patients who are taking stilbestrol, and to obese men with large breasts. Precaution I would like to warn against the use of this stain, or any other stain, on the basis of a single vaginal smear, without a full consideration of available history and physical findings. I would recommend that analysis of the vaginal smear, like any other single diagnostic procedure, be considered as a building-block to be fitted in with other blocks, in corroboration of all other associated findings, to form a diagnosis. Also, as in other laboratory procedures, the more smears that are examined, the more nearly correct will be their interpretation. The vaginal smear itself is not infallible; no staining method yet devised is infallible. This stain, perhaps, is less reliable than others in certain conditions, but it will give vital information and make such information immediately available to all who will spare a few minutes daily. Summary and Conclusion The vaginal smear has been found to be useful in the diagnosis of many hormonal conditions in the female. It is easily obtained, ancl may even be made by the patient herself 011 several days and the series carried or sent to the physician later. These smears mirror the hormonal activity in the normal cycle and reveal aberrations in the abnormal. Menopausal smears are the most easily studied, since the immediate cell changes are evident as soon as estrogenic therapy is begun, and since there are no other complicating hormones to change the picture every few days, such as are found while the ovaries are still functioning. Several good stains have been developed, opening up a new field in gynecology, but they require much time and knowledge of cytology. This modification is not offered to replace any other stain or method of staining but to make available to the gynecologist a method of staining whereby he, too, can use the knowledge that has been derived by others in their study of the more complicated stains. The procedure is so simple as to be available to all, yet yields enough detail to serve the most exacting, while obviating the time lag of all the other techniques. References 1. Stoekarrl, C. R., and Papanicolaou, G. N.: The Existence of a Typical Oestrous Cycle in the Guinea Pi?, with a Study of its Histological and Psychological Changes, Am. J. Anat. 22:225-283, 1917. 2. Allen, E., and Doisy, E. A.: Ovarian Hormones; Preliminary Report on its Localization. Extraction and Partial Purification, and Action in Test Animals, J.A.M.A. 81:819-821 (Sept. 8) 1923. 3. Dierks, K.: Experimentelle Untersuchungen an menschlich-er Vaginalschleimhaut. Arch. f. Gynak. 138:111-130; abstr., 137:1024-1026, 1929. 4. Papanicolaou, G. N.: Sexual Cycle in Human Female as Revealed by Vaginal Smears', Am. J. Anat. 52:519-637 (May) 1933. 5. Papanicolaou, G. N., and Shorr, E.: Action of Ovarian Follicular Hormone in Menopause, as Indicated by Vaginal Smears, Am. J. Obst. & Gynec. 31:800-831 (May) 1936 6. Geist, S. H., and Salmon, U. J.: Evaluation of Human Vaginal Smear in Relationship to Histology of Vaginal Mucosa, Am. J. Obst. & Gynec. 38:392-399 (Sept.) 1939. 7. Van Dyke, H. Ii., and Ch'en, G.: Observations on Biochemistry of Genital Tract of Female Macaque, Particularly During Menstrual Cycle, Am. J. Anat. 58:473-199 (March) 1936. 8. Zondek, B., and Stein, L.: Glycogen Content of Human Uterine Mucosa Glycopenia Uteri, J. Endocrinol. 27:395-399 (Sept.) 1940. 9. Randall, L. M., and Power, M. H.: Amounts of Glycogen in Endometrium, Proc. Staff Meet., Mayo Clin. 17:i58-l60 (March 11) 1942. 10. Spyker, M. A., and Fidler, R. S.: Glycogen Studies on Human Endometrium; Correlation of Quantitative Estimation and Qualitative Demonstration by Histological Methods, J. Clin. Endocrinol. 2:365-368 (June) 1942. 11. Papanicolaou, G. N.: New Procedure for Staining Vaginal Smears, Science 95:438-439 (April 24) 1942. 12. (a) Shorr, E.: New Technique for Staining Vaginal Smears, Science 91:321 (March 29); 579 (June 14) 1940; (b) New Technique for Staining Vaginal Smears, Single Differential Stain, Science 94:545-546 (Dec. 5) 1941. 13. Shorr, E.: Evaluation of Clinical Applications' of Vaginal Smear Method, J. Mt. Sinai Hosp. 12:667-688 (Mav-June) 1945. 14. Editorial comment, Obst. & Gynec. Sur. 1:373, 1946. 15. Greenblatt, R. B.: Personal1 communication. 16. (a) Mack, H. C.: New and Rapid Method of Staining Smears Based Upon Specific Color Reaction for Glycogen, Harper Hosp. Bull. 1:54-56 (Jan.) 1942; (b) Mack, C. H.. and Ale, T.: Appraisal of Estrogenic Activity by Vaginal Glycogen Index; Comparison of Oral and Parenteral Estrone, J. Clin. Endocrinol, 2:361-364 (June) 1942; (c) Mack. H. C.: Glycogen Index in Menopause: Study of Certain Estrogen Functions Based on a New Vaginal Smear, Am. J. Obst. & Gynec. 45:402-419 (March) 1943. 17. Nieburgs, H. E., and Greenblatt, R. B.: Specific Estrogenic and Androgenic Smears in Relation to the Fetal Sex During Pregnancy, Am. J. Obst. & Gynec. 57:356-363 (Feb.) 1949. 18. Greenblatt, R. B., Torpin, R., and Brown, W. R.: Diethyl-stibestrol; Clinical Evaluation of Various Modes of Administration. South. M. J. 33:1276-1285 (Dec.) 1940. 19. Greenblatt, R. B.: Vaginal Smear as a Guide to Estra genie Therapy, J.M.A. Georgia 30:297-303 (July) 1941. 20. Bonime, R. G.: Application of Vaginal Smear to Diagnosis of Pregnancy; Preliminary Report, Am. J. Obst. & Gynec. 58:524-531 (Sept.) 1949. 21. Papanicolaou, G. N.: Diagnosis of Pregnancy by Cytologic Criteria in Catheterized Urine. Proc. Soc. Exper. Biol. & Med. 67:247-249 (Feb.) 1948. 22. Nieburgs, H. E., and Greenblatt, R. B.: Significance of Specific Estrogenic, Progestogenic and Androgenic Smears in Menstrual Disorders' and in Pregnancy, South. M. J. 41:972-980 (Nov ) 1948. 23. Nieburgs, H. E.: Gestational Changes in Vaginal Epithelium and Their Relations to Sex of Foetus, J. Obst. & Gyn-aec. Brit. Emp. 54:653-656 (Oct.) 1947. 24. Hall, G. V.: Vaginal Cornification Phases During Pregnancy; Their Prognostic Significance, J. Clin. Endocrinol. 5:34-37 (Jan.) 1945. 25. Benson. II. C., and Traut, H. C.: The Vaginal Smear as a Diagnostic and Prognostic Aid in Abortion, J. Clin. Endocrinol. 10:675-686 (July) 1950. 26. Schuman, W.: Possible Significance of Vaginal Smears in the Diagnosis of Certain Disturbances of Pregnancy, Am. J. Obst. & Gynec. 47:808-816 (June) 1944. |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-013.pdf |
Document Sort | all; nchh-17 |
Article Title | A Simplified Technique For Staining The Vaginal Smear For Immediate Appraisal Of Endocrine Activity |
Article Author | John P. U. Mcleod |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-013 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | keep |
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