By a newly devised double-canule method, menorrhagic and metrorrhagic bloods were collected directly from the uterine cavity and the morphological characteristics of cellular elements were described in detail in cases of eumenorrhea, functional uterine bleeding, incomplete abortion, incomplete separation of placenta, ectopic pregnancy, hydatidiform mole, malignant chorionepithelioma and endo metrial carcinoma. The results obtained have led the author to the conclusion that the cytological diagnosis of uterine malignancies was more difficult than the histological one beeause a great variety of atypical cells, which were difficult to discern from true-malignant cells, was found frequently in menorrhagic and metrorrhagic bloods of patients without malignancy (Author's abstract).

View full abstract

For the fixing of smears a 95% alcohol/ether equivalent solution is commonly used, but drying before or after fixing is held to be a procedure which shuold be aboided. In the case of specimens collected in remote areas, however, it is inconvenient to mail or transport them as soaked in a fixing solution, and Sagi and others state that by the use of a 90% aceton fixing solution, there is no obstruction to examination for at least 2 weeks even if the specimen is left to dry naturally after fixing. Therefore we also examined this point.
In our experiment covering 4 cases of the cervical cancer, 13 cases of erosio portionis, and 3 cases of pregnancy, vaginal smear specimens from the cases were left to dry naturally after fixing for 30 minutes in a 90% aceton and a 95% alcohol/ether equivalent solutions respectively. Immediately afterward and on the 1st, 2nd, 3rd, 5th, and 7th days, they were examined mainly with Papanicolaou's stain and partly with Shor's stain (Sugimoto/Matsueda variation), hematoxylin/eosin stain, Giemsa's stain, Feulgen's stain, and a fluorescent microscope using acridine orange and studied by comparison.
As a result, in the specimens left to dry naturally after fixing for 30minutes in aceton and alcohol/ether respectively, the staining affinity of cells was found to be almost normal on the 1st and 2nd days after fixing, but on the 3rd day, to decline slightly. There was a tendency for folds to form in the protoplasma marginal portion of superficial cells, but the nuclear structure of atypical cells was relatively clear.
On the 5th day, the staining affinity declined and the protoplasma of superficial cells shrank, so that the protoplasma marginal portion tended to stain heavily, the outline of nuclei became unclear, and transparentized rings were visible around the nuclei. On the 7th day, the staining affinity declined further, the protoplasma form of superficial cells seemed to collapse somewhat, the nuclear marginal portion became indistinct, and the nuclear structure of atypical cells became unclear. In the Shorr's staining and four other staining methods, too, the staining affinity declined likewise after the 3rd-5th day.
A comparison of the merits and demerits of fixing methods is considerably difficult as it involves various problems such as specimen collection, smearing method, staining solution and staining method, but according to the results we examined day by day, no striking difference in the staining affinity of cells was seen between the two groups of specimens left to dry naturally after fixing for 30 minutes in aceton and ether/alcohol respectively. Therefore, aceton is not particularly considered an excellent fixing agent.
Meanwhile, we think that both fixing methods interfere with the distinguishing of deep cells and atypical cells because the staining affinity of cells declines from the 5th day onward, but that they withstand use in primary examining jobs such as group medical checkups.

View full abstract