Experience with cytologic tumor diagnosis by the papanicolaou method

SELECTED

Volume 61 Number 2

469

ABSTRACTS

with marked masculinizing symptoms. This patient experienced a sudden catastrophic intraabdominal hemorrhage. On operation, bilateral Krukenberg tumors were found, one of which showed extensive carcinomatous infiltration of a large blood vessel. The diagnosis was oonfirmed microscopically after hysterectomy and bilateral salpingo-oophorectomy had been performed. Differential diagnosis on the basis of developing and acute symptoms lay between the correct pathologic condition and ruptured ectopic gestation. In the discussion, the author propounds the theory that the virilism which developed was due to the lack of production of female sex hormone resulting from tumor growth, which, in turn, allowed unopposed activity of male hormone produced by the adrenal cortex. L. B. WINKELSTEIN Hengstmann, H. and Wittekind, D.: Experience With PapaniCOlaOu Method, Med. Klin. 45: 463, 1950.

Uytologic

Tumor Diagnosis

by the

The authors describe the Papanieolaou technique in detail, and compare it with their experiences with May-Griinwald, Giemsa, and hematoxylin-eosin stains. They point out that neither the dyes used, nor the wet-flxation method employed are new developments, nor are auy new characteristics of tumor cells revealed. The advantages of wet-fixation are better preservation of tumor cell nuclei, lack of staining of extracellular material, and hence better transparency of the slides. The latter factor permits better visualization of the nuclear membrane. A simplified counterstain with eosin or lichtgruen is recommended to replace the complicated Papanicolaou plasma counterstain. IRVING

Sered, Harry, Falls, Frederick H., and Zmmo, Tuberculosis, J. A. M. A. 142: 547, 1950.

Bruce

P.:

Streptomycin

L.

FRANK

in Gynecologic

The authors report 16 cases of genitoperitoneal tuberculosis. These patients were subjected to streptomycin therapy for 6 to 8 weeks, operated upon, and given another threeweek course of treatment with the drug postoperatively. At the outset 2 Gm. of streptomycin were used daily but with the onset of vestibular symptoms this was reduced to 1 Gm. per day. All receiving the drug showed some clinical improvement and when the drug was given 6 to 8 weeks preoperatively there seemed to be fewer technical difhculties encountered in the operation. In this study total hysterectomy was the surgical procedure in 13 cases, subtotal hysterectomy in 2 cases, bilateral salpingo-oophorectomy in one. Total hysterectomy and bilateral salpingo-oophorectomy are advised wherever ovaries are involved, with primary closure of the vagina and abdominal wall, and total hysterectomy and at least bilateral salpingectomy should be performed whenever tuberculous peritonitis is found, if the patient is a good surgical risk. Those patients with lesions elsewhere may require streptomycin for longer periods postoperatively. The only complication in this series occurred in one patient who became streptomycin fast and subsequently died. WM. BERMAN

Gynecologic Operations Werner, P.: 1950.

Vaginal

Salpingectomy

for Tubal

Pregnancy,

Wien. klin. Wchnschr.

62: 248,

Operation by the vaginal route is offered as the method of choice for cases of tubal pregnancy in which (a) the palpable mass is not larger than a hen’s egg, (b) a diagnostic colpotomy has been necessary, and local findings seem to permit proper exposure, and (c) there is no active intraperitoneal bleeding. Through the posterior colpotomy wound, the size and position of the mass are determined digitally. After appropriate dissection, an anterior colpotomy is then created, through which the tubal mass is delivered into the vagina and ablated. The tubal stump is then