Melanoma screening: report of a survey in occupational medicine.

BACKGROUND: Epidemiological studies concerning melanoma are most often performed by general practitioners and dermatologists in patients previously aware of the risk of nevi. OBJECTIVE: To determine the efficiency of early detection of melanoma by occupational medicine specialists trained in the use of ABCDE criteria during annual systematic examination of workers. METHODS: A total of 370 subjects with suspect lesions that demonstrated at least 2 of 5 ABCDE criteria were selected from 65000 employees examined; these subjects were requested to see their physician about possible excision. Of the 370 subjects, 273 (73.8%) were seen at a second-year follow-up visit to determine their outcome. RESULTS: Among the 273 subjects who were seen again, 172 (63.0%) had consulted a physician. For the 101 subjects who had not seen a physician, the main reason was the negligence (86.1%). A total of 353 atypical nevi were observed. The mean number of ABCDE criteria noted per lesion was 2.6. Lesion diameter greater than 6 mm was the most frequent (80.5%) and enlargement the least frequent criteria seen; heterochromous coloration and diameter greater than 6 mm was the most common association (54.5%). Five histologically confirmed melanomas were found among nevi excised in 78 subjects. CONCLUSION: This screening approach seems efficient for the early detection of melanoma, demonstrating an incidence of 7.7 per 100000 vs. 9 per 100000 in the general French population.

[Respiratory allergies among bakers and pastry cooks: epidemiologic survey done in 1991 by the occupational physicians of the Loire-Atlantique]. / Allergies respiratoires des boulangers et des pâtissiers: enquête épidémiologique réalisée en 1991 par des médecins du travail de Loire-Atlantique.

The aim was to study the prevalence of respiratory allergy (rhinitis and asthma) in a population of bakers and pastrycooks. In 1991, 485 bakers and pastry cooks were examined by 27 work-physicians of Loire-Atlantic. The investigation was composed of a standardised questionnaire (signs of respiratory function, atopic history, smoking of tobacco ...), a clinical examination, and tests of respiratory function. An allergy assessment was made of all subjects with symptoms. 14.4% of subjects had rhinitis and 6.4% asthma. Development of these pathologies was clearly job-related for 2/3 of those with rhinitis and more than half of the asthmatics (55%). Occupational rhinitis and asthma were significantly more frequent in bakers than in pastrycooks and were linked to atopic history. Occupational asthma was associated with length of exposure to flour and with occupational rhinitis. In conclusion, these findings are comparable with or a little less than those that have been reported in occupational literature. They under-estimate the importance of the problem because of the occupational selection effect that is associated with these pathologies. Rhinitis and asthma are 1.5 to 3 time more common in bakers than in pastrycooks.

[Respiratory allergies among symptomatic bakers and pastry cooks: initial results of a prevalence study]. / Allergies respiratoires des boulangers-pâtissiers symptomatiques: premiers résultats d'une étude de prévalence.

A survey was carried out on respiratory symptoms and skin prick response to common allergens, storage mite and occupational allergens. Among 178 symptomatics bakers and pastry workers from small businesses in western France, only 65 people underwent skin prick and specific-IgE. 12 (18%) workers were skin positive to at least one common or occupational allergens. The more often skin positive were D. Ptero. mite 36 (57%); Alpha amylase 23 (35%); wheat flour 17 (26%); saccharomyces cerevisiae 16 (25%); Ephestia 15 (24%). The sensitivity of skin test was better than specific IgE for D. Ptero. Mite 36 (57%); and Alpha amylase 23 (35%). The sensitivity of specific IgE was better than skin test for wheat flour 26 (45%) and rye flour 23 (40%). Occurrence of skin positive to occupational allergen among symptomatics with rhinitis and asthma is much more frequent in workers with skin positive to common allergens (40/36) than in workers with skin negative (8/20). Atopy must be regarded as an important predisposing factor for skin sensitisation to occupational allergens. We conclude in the necessity of a standardised allergologic exploration to be done in symptomatics bakers.

Quantitative assessment of the glandular activity of endocrine cells of gastrointestinal mucosae by computer-assisted analysis of ultrastructural images: methodology.

A method is described for studying the morphological features of endocrine cells of gastrointestinal mucosae in man and some animal species by semi-automatic analysis of ultrastructural images. The method enables possible ultrastructural variations in gastrointestinal endocrine glandular cells of different types to be determined with an acceptable margin of error. Various causes of error are investigated. It is found that the main cause is the choice of microscope magnification, despite the corrections made. The factor of inconsistency in the reproducibility of measurements performed by several operators is also calculated.

A new technique for staining sections and recovering celloidin film in high resolution autoradiography.

Ultrathin sections are stained immediately after cutting by placing them in contact with staining solution and then placed on a slide covered by a celloidin film. This method largely avoids precipitates of heavy metals. The recovering of celloidin film is improved using a stainless steel basket. This technique is far more reliable than that involving use of a filter paper.