Transformation zone location and intraepithelial neoplasia of the cervix uteri.

We examined the relationship between the frequency of premalignant lesions of the cervix and location of the transformation zone on the cervix among 8758 women as assessed using cervicography. An endo- and exocervical smear test was performed at the same time. Women with smear test classified CIN I or more were recalled and any abnormal area was biopsied under colposcopy. The transformation zone was located on the exocervix in 94% of women younger than 25 years old; as age increased, the proportion of women with a transformation zone located on the exocervix steadily decreased to reach less than 2% after 64 years old. As compared with women having a transformation zone in the endocervical canal, the age-adjusted likelihood of discovering a histologically proven dysplastic lesion was 1.8 times more frequent among women with a transformation zone located on the exocervix (95% confidence interval 1.1-2.9). This higher frequency seemed not attributable to a lower sensitivity of the smear test when the transformation zone was hidden. The results also showed that deliveries tended significantly to maintain the transformation zone on the exocervix. Parity is a known risk factor for cervix cancer, but the mechanism by which it favours malignant lesions remain unknown. Our results suggest that with increasing numbers of livebirths, the transformation zone is directly exposed for longer periods to external agents involved in dysplastic lesions

Adrenoceptors and regulation of intestinal tone in the isolated colon of the mouse.

Adrenaline, noradrenaline, phenylephrine, dopamine, clonidine and apomorphine at low concentrations (from 10(-9) M to 10(-6) M) contracted the longitudinal muscle of the isolated distal colon of the mouse. Phentolamine, tetrodotoxin and indomethacin antagonized these contractile responses. Yohimbine antagonized them at lower concentrations than prazosin. Dopamine and clonidine had the same contractile activity on preparations from mice pretreated with 6-hydroxydopamine (6-OHDA). Isoprenaline (10(-9) to 3 X 10(-7) M) induced relaxations of the colon which were antagonized by propranolol. At higher concentrations, adrenaline and noradrenaline (from 3 X 10(-7) M), dopamine (from 3 X 10(-5) M), phenylephrine (from 3 X 10(-6) M) and apomorphine (from 10(-4) M) relaxed the colon. Clonidine (10(-6) to 3 X 10(-5) M) inhibited the spontaneous activity of the colon but never induced relaxations. At 10(-4) and 10(-3) M clonidine elicited contractions. Prazosin antagonized the inhibitory effect of phenylephrine and clonidine, a mixture of propranolol and prazosin antagonized the relaxations to adrenaline, noradrenaline and dopamine and unmasked contractions that were sensitive to yohimbine and tetrodotoxin. The relaxations induced by apomorphine and the contractions induced by clonidine (greater than 10(-6) M) were resistant to all these antagonists. Electrical field stimulation (1 ms, 2 Hz, 2-20 V) of the mouse colon induced contractile responses which increased with the frequency of the stimulus. After cessation of stimulation at 4 Hz a rebound contraction was generally observed, followed by a progressive decline in tone. In the presence of atropine, the contractile response to field stimulation was abolished and transformed into a rapid and sustained relaxation. A rebound contraction was always observed after cessation of stimulation. The responses to electrical stimulation (in the presence or absence of atropine) were abolished by tetrodotoxin. The rebound contractions were abolished by indomethacin. The relaxations induced in the presence of atropine were not modified by phentolamine, propranolol, guanethidine, methysergide, mepyramine, cimetidine or naloxone. Tetrodotoxin (from 3 X 10(-8) M) caused a sustained contraction of the colon with increased spontaneous activity. This contraction was not modified by atropine, phentolamine, propranolol, guanethidine, methysergide, mepyramine, cimetidine, naloxone, but was abolished by preincubation of the preparation with indomethacin. These results indicate that, at low concentrations, various sympathomimetics contracted the mouse distal colon by stimulating alpha 2 presynaptic adrenoceptors.(ABSTRACT TRUNCATED AT 400 WORDS

APPORT DU CT DANS LE DIAGNOSTIC ET LE TRAITEMENT DE L'ASPERGILLOME

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Improved cancer detection in automated breast ultrasound by radiologists using Computer Aided Detection

Contains fulltext : 173113.pdf (publisher's version ) (Closed access)OBJECTIVE: To investigate the effect of dedicated Computer Aided Detection (CAD) software for automated breast ultrasound (ABUS) on the performance of radiologists screening for breast cancer. METHODS: 90 ABUS views of 90 patients were randomly selected from a multi-institutional archive of cases collected between 2010 and 2013. This dataset included normal cases (n=40) with >1year of follow up, benign (n=30) lesions that were either biopsied or remained stable, and malignant lesions (n=20). Six readers evaluated all cases with and without CAD in two sessions. CAD-software included conventional CAD-marks and an intelligent minimum intensity projection of the breast tissue. Readers reported using a likelihood-of-malignancy scale from 0 to 100. Alternative free-response ROC analysis was used to measure the performance. RESULTS: Without CAD, the average area-under-the-curve (AUC) of the readers was 0.77 and significantly improved with CAD to 0.84 (p=0.001). Sensitivity of all readers improved (range 5.2-10.6%) by using CAD but specificity decreased in four out of six readers (range 1.4-5.7%). No significant difference was observed in the AUC between experienced radiologists and residents both with and without CAD. CONCLUSIONS: Dedicated CAD-software for ABUS has the potential to improve the cancer detection rates of radiologists screening for breast cancer

Sun exposure and sun protection in young European children: An EORTC multicentric study

Most European children experience exposure to the sun during the summer holidays. The aim of this study was to examine the behaviour of European children when in the sun during their holidays. In 1995-1997, a total of 631 young children were recruited during a multicentric study in Belgium, Germany, France and Italy. For each holiday period from birth, parents gave detailed information on sun exposure and child behaviour. Predictors and trends over time of sun protection were investigated. Forty percent of children were exposed to sunlight in the first and 86% in the sixth year of life. At the same time, the number of children who experienced sunburns rose from 1 to 23%. In the whole period of 6 years, only 8% of children always wore trousers and shirt when in the sun, while 25% children always used a sunscreen. The proportion of sun-exposed children who used sunscreen was stable with age (∼50%), while those who always wore trousers and shirts dropped from 46% (1st year) to 19% (6th year). Multinomial logistic regression showed that sunscreen use, but not the wearing of clothes was associated with sun-sensitivity. In summary, sun exposure increases steadily, while sun protection decreases in the first 6 years of life in our cohort of children. In this cohort, use of a sunscreen was much more frequent than the wearing of clothes and a reduction in sun exposure. © 2002 Elsevier Science Ltd. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe