The Isaacs Endometrial Cell Sampler. An evaluation in 100 patients with postmenopausal bleeding.

The Curity Isaacs Endometrial Cell Sampler was used to obtain cytologic material from 100 consecutive patients presenting with postmenopausal bleeding. It was followed by uterine curettage to obtain material for histology. Satisfactory endometrial aspiration smears were obtained from 92 patients, whereas curettage yielded endometrial tissue in only 48. Of 17 patients with histologic confirmation of malignancy, 7 had smears diagnosed as showing malignancy, and 7 had smears showing hyperplastic changes; 3 of the aspiration smears were judged to be unsatisfactory for cytologic evaluation. All the carcinomas were found in the hyperplastic, malignant or unsatisfactory smears. This technique is worthy of further study.

Minor gynaecological outpatient operations.

Altogether 143 patients had minor gynaecological operations performed under general anaesthesia in the outpatient department. This method proved to be very acceptable to patient, gynaecologist, and anaesthetist. No complications occurred requiring admission to hospital, and the short recovery time confirmed the safety of early discharge from hospital. This procedure had a beneficial effect on the waiting list, and expensive beds were used more efficiently for major surgical cases. It is recommended that this procedure should be more widely practised, provided that the patients are adequately screened.

Prostacyclin formation by the pregnant human myometrium.

Human myometrium taken between 15 and 42 weeks of pregnancy released a material in vitro which possessed anti-aggregatory activity. This material parallelled authentic prostacyclin in this action; it possessed a similar stability at alkaline pH and generation of activity was inhibited by indomethacin. Production of the prostacyclin-like material by the myometrium was similar at weeks 15 and 38 of pregnancy but a 4-fold increase in synthesis had occurred by 40 weeks. It is suggested this increase may be important for parturition.

Central neurocytoma arising within a mature cystic teratoma of the ovary.

Tumors of central nervous system elements are uncommon in cystic teratomas and tend to be derived from glial or primitive neuroectodermal cells. We describe the case of a 23-year-old woman with a central neurocytoma arising in an otherwise mature cystic teratoma of the ovary. Histologically, the neurocytoma was composed of collections of oligodendroglioma like cells in a fibrillary matrix. Cytologically the tumor was identical in appearance to central neurocytomas occurring within the adult brain. It expressed synaptophysin and neuron-specific enolase, confirming its neuronal lineage, but not glial fibrillary acidic protein. The site of the tumor recapitulated the typical location of neurocytomas adjacent to the lateral ventricle in that in abutted onto an ependyma-lined cyst within the teratoma. The patient remains well and free of tumor 1 year after cystectomy, in keeping with favorable follow-up data for surgically excised central neurocytomas within the brain.