[Suspicious pigmented skin lesions. Screening campaign by occupational physicians in the Provence-Alpes-Côte d'Azur region]. / Lésions cutanées pigmentées suspectes. Campagne de dépistage par les médecins du travail de la région Provence-Alpes-Côte d'Azur.

OBJECTIVE: Cutaneous melanoma prevention has become a public health issue. The incidence of this cancer has been steadily growing for 50 years, and the related death ratio is not decreasing. Today, the surgical resection of a thin lesion is the only validated curative treatment. The early detection of melanoma represents a major line in the management of such tumours. METHODS: Occupational physicians of the PACA area were invited to participate in a campaign for the screening of pigmented suspect cutaneous lesions for 2 years. Voluntary physicians were trained to use the ABCDEF diagnostic criterion. Lesions were detected during regular yearly consultations (1998/1999) and the data concerning the development and care of these lesions was collected during consultations over the following year (1999/2000). RESULTS: Two hundred and fifty occupational physicians of the PACA area participated in the campaign. Two pre-cancerous lesions and 10 cancers (5 melanoma and 5 pigmented basocellular carcinoma) were found among the 487 suspect lesions detected. Each melanoma had a Breslow score of less than 0.9 mm and were of good or even excellent prognosis. CONCLUSION: The cutaneous examination, although rapid, during the occupational medicine consultations, is an effective means of detecting the early onset tumoral lesions which, at that stage may potentially be cured. The ABCDEF criterion is a useful diagnostic tool and should be taught to the all the medical and paramedical staff.

Toluene and styrene intoxication route in the rat cochlea.

It is well established that organic solvents such as toluene and styrene are ototoxic in the rat; however, the intoxication route used to reach the organ of Corti is still questionable. The distribution of toluene and styrene in various tissues of Long-Evans rats (n = 2 x 8) was studied after inhalation of either 1750 ppm toluene or 1750 ppm styrene for 10 h (6 consecutive h + 4 h the following day). At the end of the solvent exposures, blood, brain, auditory nerves, the organ of Corti, cerebrospinal (CSF), and inner ear fluids (IEF) were sampled or removed to measure the rates of solvent uptake in each tissue by gas chromatography. Results indicate that CSF and IEF were free from detectable solvents, whereas the organ of Corti, the nerves, and the brain were contaminated. Therefore, both toluene- and styrene-induced hearing losses are caused by tissue intoxication rather than by fluid contamination. It is proposed that the outer sulcus is used as an intoxication route to reach the organ of Corti.

The role of glutathione and cysteine conjugates in the nephrotoxicity of o-xylene in rats.

Moderate nephrotoxicity was induced in male and female rats exposed to o-xylene for 4 h at atmospheric concentrations of approximately 3000 ppm. The xylene in vivo nephrotoxicity resulted in low enzyme leakage from the kidney into the urine. This low leakage was confirmed in 24-h urine by an increase in gamma-glutamyltranspeptidase (gammaGT), N-acetyl-beta-D-glucosaminidase (NAG) and alkaline phosphatase (ALP) activities. Compared to the control, both the 24-h urine output and the glucose excretion increased in male and female rats. These increases were probably a result of damage to the renal proximal tubules. The role of the metabolic pathway of glutathione in the emergence of the renal damage observed with o-xylene was investigated in rats. Recent studies indicate that the metabolic pathway of glutathione may be a bioactivation pathway, which is responsible for nephrotoxic effects with several drugs or chemicals. The renal toxicity of three synthesized o-xylene thio-conjugates was investigated in several groups of female rats. Administration of S-(o-methylbenzyl)glutathione (i.p., 1 mmol/kg), S-(o-methylbenzyl)cysteine (per os, 1 mmol/kg) or N-acetyl-S-(o-methylbenzyl)cysteine (i.p., 0.75 mmol/kg) to female rats did not induce renal toxicity, as monitored by urinary biochemical parameters (gammaGT, NAG, ALP, glucose). The data obtained suggest that the glutathione pathway would appear to be only detoxication, and probably does not contribute to the renal toxicity of o-xylene in female rats. Thus, either another metabolic pathway or other intermediate metabolites are probably involved in the nephrotoxic action of o-xylene.

[Should occupational medicine physicians be linked to future computerized medical record networks?]. / Doit-on connecter les médecins du travail aux futurs réseaux d'information?

Upcoming reforms of the health care system place high expectations on computerized medical file networks to control medical expenditures. In France, information flow from the care delivery sector to the occupational medicine sector is often slow or incomplete. Company and social security expenditures or dysfunctions as well as patient incomfort may result. An analysis of occupational medicine practices and the needs of physicians working in this sector leads to several perspective proposals for improvement including access to future computerized medical file networks and the health data card Sesame.

Combined effects of simultaneous exposure to toluene and ethanol on auditory function in rats.

Three experimental groups and one control group of Long-Evans rats were used to study the combined effects of toluene and ethanol on auditory function. The first experimental group was exposed to toluene vapors (1750 ppm, 6 h/day, 5 days/week, 4 weeks), the second one was daily gavaged with a saline solution of ethanol (4 g/kg, 4 weeks), and the last group was simultaneously exposed to both toluene and ethanol. Auditory function was tested by recording brain stem (inferior colliculus) auditory-evoked potentials for audiometric frequencies ranging from 2 to 32 kHz. Urinary hippuric acid was dosed to check the toluene metabolism during the experiments. Ethanol clearly modified the toluene metabolism in the present experimental conditions. As a result, the hearing loss induced by a simultaneous exposure to both ethanol and toluene was larger than that induced by exposure to toluene alone.

Postnatal hepatic and renal consequences of in utero exposure to halothane or its oxidative metabolite trifluoroacetic acid in the rat.

In utero exposure of rats to low levels of the anaesthetic halothane has been reported to produce ultrastructural changes in the liver and kidney at birth. The current study examined the postnatal functional capacities of the liver and the kidney following prenatal exposure to halothane. Halothane or its oxidative metabolite trifluoroacetic acid (TFAA) were given to Sprague-Dawley rats on gestational days 10-20. Halothane was administered by inhalation at concentration of 50 or 500 ppm 6 h-1 day-1, and TFAA was administered by gavage at doses of 75 or 150 mg kg-1 day-1. The exposed offsprings were examined on postnatal days 3, 12 or 49 for hepatic and renal biochemistry and/or function through measurements of several serum and urinary parameters. Neither halothane nor TFAA treatments had statistically significant effect on litter size, neonatal survival or postnatal growth. Both prenatal halothane and TFAA exposure produced changes in liver biochemistry of newborns, as indicated by significant increases in the serum activities of glutamate dehydrogenase and aspartate aminotransferase. In addition, TFAA caused a functional deficit of the proximal tubule in newborns, as evidenced by the significant increase in the urinary excretion of beta 2-microglobulin. However, these hepatic and renal alterations were restricted to the early postnatal period and were no longer observed by postnatal day 49. It is concluded that prenatal exposure to relatively low levels of halothane can cause slight and transient changes in the neonatal rat liver.

Hepatotoxicity of N, N-dimethylformamide in rats following intraperitoneal or inhalation routes of administration.

Male Sprague-Dawley rats were administered a single intraperitoneal injection of N, N-dimethylformamide (DMF, 0.01-1.5 g kg-1) or were exposed for 4 h to DMF vapours (75-900 ppm). The serum activities of the enzymes sorbitol deshydrogenase and glutamate deshydrogenase were used as indicators of liver damage, and were determined at 24, 48 or 72 h post-treatment. Following either route of administration DMF caused concentration-dependent elevations in enzyme activities, the maxima of which occurred later after administration of higher concentrations of DMF than after lower concentrations.