Development and validation of a computerized cytomorphometric method to assess the maturation of vaginal epithelial cells

Laak, J.A.W.M. van der; Schijf, C.P.T.; Kerstens, Harold M.J.; Heijnen-Wijnen, Tiny H.M.; Wilde, P.C.M. de; Hanselaar, A. G. J. M.

doi:10.1002/(sici)1097-0320(19990301)35:3<196::aid-cyto2>3.0.co;2-v

Cited by 31 publications

(19 citation statements)

References 7 publications

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“…The components of vaginal maturation index are usually used as a measure of estrogen effects in adult women (Hammond 1977; van der Laak et al 1999). In a “normal child,” one would expect almost 100% parabasal cells, few intermediate, and 0% superficial cells, for a vaginal maturation index of nearly 0%, whereas a peripubertal girl may have a virtually no parabasal, 90% intermediate, and about 10% superficial for a vaginal maturation index of about 55%.…”

Section: Discussionmentioning

confidence: 99%

Pilot Studies of Estrogen-Related Physical Findings in Infants

Bernbaum

Umbach

Ragan

et al. 2008

Environ Health Perspect

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BackgroundSoy formula containing estrogenic isoflavones is widely used in the United States. Infants consuming soy formula exclusively have high isoflavone exposures. We wanted to study whether soy formula prolonged the physiologic estrogenization of newborns, but available quantitative descriptions of the natural history of breast and genital development are inadequate for study design.ObjectiveWe piloted techniques for assessing infants’ responses to the withdrawal from maternal estrogen and gathered data on breast and genital development in infants at different ages.MethodsWe studied 37 boys and 35 girls, from term pregnancies with normal birth weights, who were < 48 hr to 6 months of age, and residents of Philadelphia, Pennsylvania, during 2004–2005. One-third of the children of each sex and age interval were exclusively fed breast milk, soy formula, or cow-milk formula. Our cross-sectional study measured breast adipose tissue, breast buds, and testicular volume; observed breast and genital development; and collected vaginal wall cells and information on vaginal discharge. We assessed reliability of the measures.ResultsBreast tissue was maximal at birth and disappeared in older children, consistent with waning maternal estrogen. Genital development did not change by age. Breast-milk secretion and withdrawal bleeding were unusual. Vaginal wall cells showed maximal estrogen effect at birth and then reverted; girls on soy appeared to show reestrogenization at 6 months.ConclusionsExamination of infants for plausible effects of estrogens is valid and repeatable. Measurement of breast tissue and characterization of vaginal wall cells could be used to evaluate exposures with estrogen-like effects.

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Section: Discussionmentioning

confidence: 99%

Pilot Studies of Estrogen-Related Physical Findings in Infants

Bernbaum

Umbach

Ragan

et al. 2008

Environ Health Perspect

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“…The blood flow waveform score (from the Doppler flow waveform) ranged from 0 (normal arterial flow) to 2 (abnormal high‐resistance flow with retrograde diastolic flow; Figure 2). In this study, more quantitative measurements were performed from the elastographic and Doppler flow waveform images using ImageJ 22 , 23 …”

Section: Methodsmentioning

confidence: 99%

“…Elastographic color variance images were imported into ImageJ, where they were scaled and cropped for the area of interest. Trigger point areas were then calculated similarly to automated cell‐counting methods 23 . Briefly, the image was converted to binary; the dark areas were automatically selected; and the area was calculated on the basis of scaling (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Objective Sonographic Measures for Characterizing Myofascial Trigger Points Associated With Cervical Pain

Ballyns¹,

Shah²,

Hammond³

et al. 2011

Journal of Ultrasound in Medicine

132

120

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Objectives The purpose of this study was to determine whether the physical properties and vascular environment of active myofascial trigger points associated with acute spontaneous cervical pain, asymptomatic latent trigger points, and palpably normal muscle differ in terms of the trigger point area, pulsatility index, and resistivity index, as measured by sonoelastography and Doppler imaging. Methods Sonoelastography was performed with an external 92-Hz vibration in the upper trapezius muscles in patients with acute cervical pain and at least 1 palpable trigger point (n = 44). The area of reduced vibration amplitude was measured as an estimate of the size of the stiff myofascial trigger points. Patients also underwent triplex Doppler imaging of the same region to analyze blood flow waveforms and calculate the pulsatility index of blood flow in vessels at or near the trigger points. Results On sonoelastography, active sites (spontaneously painful with palpable myofascial trigger points) had larger trigger points (mean ± SD, 0.57 ± 0.20 cm2) compared to latent sites (palpable trigger points painful on palpation; 0.36 ± 0.16 cm2) and palpably normal sites (0.17 ± 0.22 cm2; P < .01). Analysis of receiver operating characteristic curves showed that area measurements could robustly distinguish between active, latent, and normal sites (areas under the curve, 0.9 for active versus latent, 0.8 for active versus normal, and 0.8 for latent versus normal, respectively). Doppler spectral waveform data showed that vessels near active sites had a significantly higher pulsatility index (median, 8.3) compared to normal sites (median, 3.0; P < .05). Conclusions The results presented in this study show that myofascial trigger points may be classified by area using sonoelastography. Furthermore, monitoring the trigger point area and pulsatility index may be useful in evaluating the natural history of myofascial pain syndrome.

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“…In order to detect objective signs of VVA [10,15], we performed, under speculum examination, the MI on specimens obtained directly from the lateral upper vaginal walls [16] and we filled in the vaginal health index score (VHIS) during the follicular phase of the menstrual cycle [17]. The MI was scored as estrogenic (percentage of superficial cells) and progestogenic (percentage of intermediate cells) [16]. The VHIS includes five measures: elasticity, fluid volume, pH, epithelial integrity, and moisture.…”

Section: Methodsmentioning

confidence: 99%

Effect of local estrogen therapy (LET) on urinary and sexual symptoms in premenopausal women with interstitial cystitis/bladder pain syndrome (IC/BPS)

Gardella¹,

Iacobone²,

Porru³

et al. 2015

Gynecological Endocrinology

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The association between vulvodynia and interstitial cystitis/bladder pain syndrome (IC/BPS), a chronic, debilitating disease of unknown etiology, may involve sex hormone-dependent mechanisms regulating vulvo-vaginal health. We aimed to prospectively investigate the effects of 12 weeks of local estrogen therapy (LET) on urinary/bladder and sexual symptoms in premenopausal women with IC/BPS. Thirty-four women (mean age: 36.1 ± 8.4) diagnosed with IC/BPS were treated vulvo-vaginally three-times/week with estriol 0.5 mg cream and tested by validated questionnaires (ICSI/ICPI, pain urgency frequency [PUF], female sexual function index [FSFI]) and by cotton swab testing, vaginal health index (VHI) and maturation index (MI) before and after treatment. Vulvodynia was present in 94.1% of IC/BPS women. A significant positive effect of LET was evident on urinary and sexual function (p < 0.001, for both) following 12 weeks, as well as an improvement of the VHI (p < 0.001) and the MI (p < 0.04). The results of this open study indicate that 12 weeks of local estriol cream at vaginal and vestibular level may ameliorate urinary/bladder pain symptoms, as well as may improve domains of sexual function. The association between vulvar pain and bladder pain could, therefore, be related to a vaginal environment carrying signs of hypoestrogenism, but further studies are needed to clarify this issue.

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Development and validation of a computerized cytomorphometric method to assess the maturation of vaginal epithelial cells

Cited by 31 publications

References 7 publications

Pilot Studies of Estrogen-Related Physical Findings in Infants

Pilot Studies of Estrogen-Related Physical Findings in Infants

Objective Sonographic Measures for Characterizing Myofascial Trigger Points Associated With Cervical Pain

Effect of local estrogen therapy (LET) on urinary and sexual symptoms in premenopausal women with interstitial cystitis/bladder pain syndrome (IC/BPS)

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