Uterine microcurettage with combined endometrial histopathology and cytology. An alternative to conventional curettage

A new disposable mechanical curette, the Inocurette, was used to obtain endometrial samples for histopathology and cytology. The instrument was tested on 120 patients; 37 patients were known from a previous conventional curettage (D & C) to have an endometrial cancer and 83 patients were referred to the County Hospital of Trelleborg for curettage because of dysfunctional bleedings. In all 120 patients a D & C followed the microcurettage procedure. The samples were randomized, coded and analyzed blind without any clinical information. In all but 3 patients with a known endometrial cancer, sufficient microcurettage sample material for either histopathology or cytology was obtained. In all but one of these 34 patients either a malignant diagnosis or seriously atypical cells were found. Using only cytology five out of 34 samples were designated adequate but normal. In a further 5 of the 37 patients the samples obtained at the subsequent D & C were inadequate for diagnosis; one sample was denoted as normal. In the 83 patients with dysfunctional bleedings, sufficient material for diagnosis after microcurettage, cytology and D & C was obtained in 74, 83 and 79 patients respectively. One endometrial cancer was disclosed by all three methods. Inocurette sampling causes little discomfort and requires no special training. The combined microcurettage--cytology procedure may be recommended as an alternative to conventional curettage, though, for the time being, D & C should not be replaced for cytology alone.

The Bucharest multifactorial prevention trial of coronary heart disease. General methodology and risk factor correction after five year follow-up (1971-1977)

Both the intervention and the control group included each 5000 men aged 40-60 years, randomly selected by their home address in five districts of the city of Bucharest. The intervention group underwent an "at entry" examination for risk factor detection (high serum cholesterol, high blood pressure, overweight, diabetes, minor ECG abnormalities, family history) and subsequently a five-year multifactorial intervention aimed to reduce the risk factors. Both groups were followed up in this lapse of time for major end-points: myocardial infarction, stroke, sudden death. The qualitative analysis of the results used ten evolution indices based on a quantal counting and lead to a classification of risk factors which allowed the setting up of a strategy for their correction. The quantitative analysis showed the following decreases between the first and the last examination in the intervention group: for serum cholesterol greater than or equal to 250 mg/dl -17%; for cigarettes/day greater than or equal to 15-53%; for overweight greater than or equal to 30% - 13.57%; for high blood pressure -8%; for the overall risk computed by multiple regression -33.8%.

Epidemiological investigations on viral hepatitis in preschool and school communities. Note I. Prevalence and incidence of viral hepatitis and the role of the community in transmission

A transversal and longitudinal epidemiological follow up was undertaken of the viral hepatitis cases occurring in two types of children communities (kindergartens and schools). The role of organized communities in the spread of hepatitis viruses and the contribution of external factors to the maintenance of hepatitis endemicity are discussed.

[The healing process of local lesions. Heterocollagen (Pancol) in the treatment of wounds]

Pancol is a drug used for dressing wounds, its activity sharply differing from that of other agents used for local treatment of wounds. It has an activating, regulating effect, permitting the natural processes to develop, without altering them. The results, often spectacular under clinical conditions, are explained by histologic-microscopic investigations. The multiple aspects of its effect, the complexity of the local biological phenomena to which an equivalent complexity in the action of the Pancol corresponds, demands competence and experience in its application.

[Supra-vaterian duodenal ulcer perforated into the transverse colon. Severe state of cachexia]

In connection with a clinical observation the authors refer on this rare complication of duodenal ulcer situated above the Vater ampula. Fistulization in the transverse colon led to a short-circulting of the small bowel and an advanced cachectic condition. Surgery consisted in the suppression of the fistula that had developed between the duodenum and the colon, associated with anterior duodeno-papillo-antrectomy, Judo piloroplastia and bilateral, sub-diaphragmatic troncular vagotomy, and resulted in the recovery of the patient.