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Objectives: To identify risk factors and the prognosis associated with the development of multiple primary melanoma (MPM). Design: Case-comparison studies of subjects with MPM and single primary melanoma. Sequencing of CDKN2A in germline DNA. Setting: Population-based study of patients with invasive melanoma in Scotland between 1979 and 1996. Patients: For mortality studies, 108 patients with MPM and 216 single melanoma controls matched for age, sex, site, and tumor thickness. For risk factor studies, 48 patients with MPM and 48 single melanoma controls matched as above. For CDKN2A analysis, a sample of 23 subjects with MPM. Results: The development of MPM was found not to be an independent prognostic factor. The risk of MPM was greatest in those with a family history of melanoma, with large numbers of benign nevi, and the presence of clinically or histologically atypical nevi. Germline mutations of CDKN2A were present in 6 of 23 patients with MPM and in 5 cases consisted of the base pair substitution Met53Ile. Conclusions: The importance of MPM should be addressed in melanoma follow-up protocols. Those patients at greatest risk can be identified by a family history of melanoma and their mole pattern. Germline mutations in CDKN2A occur in both familial and sporadic MPM and further studies are required to determine the value of analysis of this gene in melanoma surveillance. Patients should be informed that the development of MPM does not adversely affect their prognosis. [ABSTRACT FROM AUTHOR]

Objective: To help the Mountain Rescue Association of Scotland find the best protective mountain rescue casualty bag in cold and windy conditions. The study investigated how 3 different casualty bags (labeled Bag 1, Bag 2, and Bag 3) performed in a cold (-10 degrees C, dry bulb), windy (wind speed 3.0 m x s(-1)) environment using physiological and subjective responses of the participating subjects., Methods: Eleven male subjects, aged 23.4+/-4 years, percentage body fat 15.5+/-2 (mean +/- SD). Each participated in a total of 3 tests (1 for each bag). The tests were scheduled to last 60 minutes. Core and skin temperatures (skin values were measured on the arm, chest, thigh, and calf, and a mean skin temperature was calculated) were measured during the tests. Heart rate, oxygen consumption (Vo2), and subjective cold perception ratings were also recorded at regular intervals throughout the test duration. All variables except for Vo2 and cold discomfort were adjusted for baseline., Results: There was a significant difference in the mean response between the bags for the following variables: arm, chest, thigh, calf, mean temperature, and cold discomfort., Conclusions: All 3 bags showed limited ability to protect the subjects in cold, windy conditions. However, the study shows that Bag 2 offered the least protection against the imposed environment. It is difficult to differentiate between the other 2 bags, because Bag 1 performed better than Bag 3 for arm, calf, and mean temperatures, while Bag 3 outperformed Bag 1 for chest and thigh temperatures and cold discomfort scores.