Fluorescent microscope has been used nowadays in various fields in medicine and studies of vaginal contents using this microscope have been reportethby Bertalanffy, Friedman, Bontke and others. It has been also used for screening of smears in which carcinoma cells show characteristic fiuorescency. Mizuno has already reported about the diagnostic use of this fluorescent microscope on Candidiasis, but now we are reporting here further study on vaginal contets using this microscope. Methods; Smears were taken from posterior fornix of vagina or eroded surface of the cervix. Some were fixed in a solution of equal parts of 95 per cent alchool and ether, and others were used without fixation. These were stained with 1:10000 acridine orange and examined immediately under Winkel-Zeiss flunrescent microscpoe. Results: 1. Fluorescency of exfoliative cells in vagina. a) superficial cells Generally, normal superficial cells of vaginal mucosa show weak fiuorescency, mostly green or green yellow, and occasionally light orange. Nuclei have a little stronger yellow fiuorescency and it wes particularly strong in pyknotic cells. b) intermediate or basal cells Cells from intermediate or basal zone of vaginal mucosa are more reddish. Nuclei are yellow and its structures are clear. Sometimes even nucleoli are seen. c) Carcinoma cells Cells are markedly reddish and its fluorescency is also strong. It is clearly differntiated from normal cells. Nuclei show strong fluorescency in yellow green. Chromatin structures are also clear and unequal numbers and sizes of nucleoli are seen. d) red blood cells It does not show any fluorescency and appears as only dark bluish round shadow. e) white blood cells Nuclei of polymorph white cells are seen as strong fluorescent yellow but protoplasm shows only weak fluorescency or sometimes it is hardly seen. 2. Trichomonas vaginalis In fresh wet slides, trichomonads is seen as fluorescent green or yellow green and the active movement of flagella and undulating. menbrance are seen In protoplasm, yellow small nuclei and green or orange red strongly fluorescent many granules are present. In fixed slides, the protoplasm is seen in light red. 3. Candida In fixed slides, Candida shows fluorescent red and from the particular shape of chlamydospores or pseudomycelium, its diagnosis can be readily obtained but the red fluorescency is not only for Candida but also for many other bacteria. Generally, bacteria are seen in green before fixation and red after fixation 4. otoer bacteria All bacteria from vagina are seen fluorescent red on fixed slides so we cannot differentiate it only by its fluorescency. 5. Sperm Once in a while, we find sperm in vaginal contents. Its head is fluorescent yellow and tail is fluorescent whitish orange. Discussion: We observed many factors in vaginal contents under fluorescent microscope and we obtained its clear pictures. Among many exfoliative vaginal cells from vaginal mucosa, protoplasm of superficial cells is fluorescent yellow green and cells become more reddish when it is from deeper zone of the mucosa. This tendency is particularly strong in carcinoma cells. They are fluorescent bright red. Red blood cells are seen only as shadow and readily differentiated from others. Staining technic is very simple. It is an excellent advantage for screening of cancer cells. The diagnosis of Candida can be easily obtained from its particular morphology but other bacteria stain same red after its fixation. Trichomonas has its specific fluorescency, so it is easy to differentiate from white blood cells even after cessation of its motion. As a conclusion, we may consider the fluorescent microscope is quite useful in observation and diagnosis due to its simple staining method and clear differentiation of pictures.
This is a report from a uterine cancer detection clinic which belongs to the Health Department of Osaka Prefecture. The number of first visit patients was 397 and total number including re-examined parients was 664 for two years. The age distribution was from 16 to 78 years old and its average was 40.8 years old. Concerning of the objective symptoms, 21.6% of all cancer patients had vaginal bleeding, 8.7% of them had postcoital bleeding, 33.2% had vaginal discharge, 9.3% had lumbago, 6.6% had lower abdominal pain and 20.5% had no objective symptom. For two years, 16 cancer patients were found in this clinic and it was 4. 03% of all visitors. They were consisted of two stage O (Ca. in situ), nine stage I, one stage II, on stage III, one adeno carcinoma, one carcinoma of vulva and one recurrence after the operation of the cervical cancer. Twelve out of sixteen had some objective symptoms and four had no symptom. Six out of sixteen had no pathologic finding on cervix and vulva by inspection. Only ten out of fifteen (66.6%) had colposcopically some pathologic findings but thirteen out of fifteen cytologically showed class IV or V and other two showed class III. Even in cases of cancer which were not found any pathologic lesions by inspection or colposcopy, cytology showed pathologic findings. This paper discusses of the importance of cytology on early diagnosis of uterine cancer, explainning each of cases which were found in the Toyonaka Cancer Detection Center.