Influence of PPH dendrimers' surface functions on the activation of human monocytes: a study of their interactions with pure lipid model systems.

The influence of surface functions on the interactions between Poly(PhosphorHydrazone) PPH dendrimers and human monocytes is discussed on the basis of complementary biological and physicochemical studies on membrane models (monolayers and multi-lamellar vesicles). The studies were performed on both an active and non-toxic phosphonic acid capped dendrimer and a non-active but toxic carboxylic acid capped one. On the one hand, comparative studies of the behaviour of DPPC monolayers in the presence or absence of PPH dendrimers in the subphase showed differences in the phase transitions, highlighting interactions between both dendrimers and phospholipid monolayers, with a larger incidence for the carboxylic acid capped dendrimer (negative control), validating its cellular toxicity. On the other hand, comparative biological studies (activation of human monocytes and binding of fluorescent dendrimers on human monocytes) show the pre-eminence of phosphonic acid capped dendrimers towards specific binding and subsequent activation of human monocytes.

Significant reduction in the rate of false-negative cervical smears with neural network-based technology (PAPNET Testing System).

False-negative cervical Pap smears may lead to disability or death from carcinoma of the uterine cervix. New computer technology has led to the development of an interactive, neural network-based vision instrument to increase the accuracy of cervical smear screening. The instrument belongs to a new class of medical devices designed to provide computer-aided diagnosis (CADx). To test the instrument's performance, 487 archival negative smears (index smears) from 228 women with biopsy-documented high-grade precancerous lesions or invasive cervical carcinoma (index women) were retrieved from the files of 10 participating laboratories that were using federally mandated quality assurance procedures. Samples of sequential negative smears (total 9,666) were retrieved as controls. The instrument was used to identify evidence of missed cytological abnormalities, including atypical squamous or glandular cells of undetermined significance (ASCUS, AGUS), low-grade or high-grade squamous intraepithelial lesions (LSIL, HSIL) and carcinoma. Using the instrument, 98 false-negative index smears were identified in 72 of the 228 index women (31.6%, 95% confidence interval [CI]: 25% to 38%). Disregarding the debatable categories of ASCUS or AGUS, there were 44 women whose false-negative smears disclosed squamous intraepithelial lesions (SIL) or carcinoma (19.3%; 95% CI: 14.2% to 24.4%). Unexpectedly, SILs were also identified in 127 of 9,666 control negative smears (1.3%; 95% CI: 1.1% to 1.5%). Compared with historical performance data from several participating laboratories, the instrument increased the detection rate of SILs in control smears by 25% and increased the yield of quality control rescreening 5.1 times (P < 0.0001). These data provide evidence that conventional screening and quality control rescreening of cervical smears fail to identify a substantial number of abnormalities. A significant improvement in performance of screening of cervical smears could be achieved with the use of the instrument described in this report.

Impact on the general public of media campaigns against AIDS: a French evaluation.

The article presents the results of the first national survey in a representative sample of the French population of 18 years of age and over (n = 1000; March 1990) about knowledge, attitudes, beliefs and practices toward HIV infection. It focuses on the impact of the media campaigns about AIDS and condom promotion that were initiated since April 1987 by French public health authorities. A total of 53.2% of respondents were able to correctly quote at least one of the slogans of the campaigns and 48.4% felt they have been personally influenced by the campaigns. Respectively 25.4%, 12.1%, and 11.2% declared that the campaigns have made them more concerned of individual risk of HIV infection and prompted them to condom use and HIV testing. Among heterosexually active respondents, 16.9% declared condom use in the past 12 months, age, marital status, level of education, HIV testing and self-acknowledgement of influence of campaigns being the main factors related to condom use in multidimensional analysis. Respondents who recognise having been influenced by campaigns are less likely to believe in HIV transmission through casual contact and to express discriminatory attitudes toward HIV carriers but more likely to support HIV mandatory screening for the general population. The difficulties to properly evaluate media campaigns for AIDS prevention are discussed as well as the complex trade-offs that general public information has to face between promotion of both individual behavioural change and societal support and empathy for HIV carriers and persons with AIDS.

[Experience in mass screening of breast cancer with mammography in France]. / Les expériences de dépistage de masse du cancer du sein par mammographie en France. Un protocole commun d'évaluation.

In the framework of the National Fund for Prevention, Health Education and Information, the setting-up in France, on an experimental basis, of mass breast cancer screening programs by mammography in ten departments leads to suggest a common protocol for the evaluation of these programs, before an eventual generalization to the whole country. These programs are based on common principles: local screening based on existing medical facilities, single view mammography with double reading. However, the screening organisation is different in each department according to the target population, the screening interval, the mode of invitation, the methods for arranging double reading, etc. The purpose of this article is to report on the work of the evaluation group of the ten programs, and to propose a methodology for comparing the screening experiences in order to measure the role of the organisation methods. It gives definitions and modes of calculations for the evaluation criteria in four fields: impact, quality, efficacy and cost (with details about the feasibility of data collection) and proposes a reflection on analysis techniques in order to develop an optimum mass screening strategy.

[Single-photon emission-computed tomography in evaluation of cerebral microcirculation of patients with epileptiform syndrome]. / Odnofotonnaia émissionnaia komp'iuternaia tomografiia v otsenke sostoianiia mikrotsirkuliatsii golovnogo mozga u bol'nykh s épileptiformnym sindromom.

One-photon emission computed tomography (OPECT) was used to examine 87 patients with the epileptiform syndrome. Eighty five patients had impaired drug distribution which was suggestive of varying degree cerebral circulatory disorders. OPECT with a Tc-99m-gm-pao used in patients with the epileptiform syndrome revealed the morphological substract of brain structures. OPECT findings in the patients suggested the brain structural microcirculatory changes to be diffuse and focal, of varying magnitude. There was no clear correlation between clinical manifestations and OPECT and CT findings.