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At least 685 records · Page 38Linked to original sources
PubMed2003

Celecoxib reduces skin damage after radiation: selective reduction of chemokine and receptor mRNA expression in irradiated skin but not in irradiated mammary tumor.

Inflammatory cytokine and chemokine production is mediated, at least in part, by prostaglandin E (PGE2). Cyclooxygenases, COX-1 and COX-2, are two key enzymes in the conversion of arachidonic acid to PGE2. Radiation induces the overproduction of cytokines and chemokines, and it also increases PGE2 production, both locally and systemically. In this study, we tested the effects of a COX-2 inhibitor (celecoxib) after 50 Gy radiation of MCa-35 tumor and cutaneous tissues of C3H/He mice. Preclinical toxicity endpoints and associated alterations in chemokine production and cellular infiltrates were measured. Celecoxib was given by daily gavage (50 mg/kg for 15 days), with the first dose delivered either 2 hours before, 2 days after, or 7 days after a single dose of radiation. Celecoxib-treated animals had less inflammation of the dermis compared with saline-treated controls. Severe skin dermatitis occurred in 23.8% (5/21) of mice treated with 50 Gy, whereas only 17.6%, 5.3%, and 11.1% of mice in the 2-hour pre-, or the 2-day post-, and 7-day postirradiation groups, respectively, had severe dermatitis on day 20. The decreased skin toxicity scores were associated with a reduction of both blood vessels and focal necrosis in MCa-35 tumors. Celecoxib also significantly decreased C-C family chemokine (Rantes and MCP-1) mRNA expression in irradiated skin tissues, but not in tumor tissues, which was accompanied by a decrease in skin mRNA expression of both C-C (CCR2 and CCR5) and C-X-C (CXCR2 and CXCR4) chemokine receptors. A significant positive correlation was also found between skin damage (skin scores) and chemokine and its receptor mRNA expression in radiation-treated mice. Finally, celecoxib also decreased the infiltration of monocytes and neutrophils in locally irradiated tumor and surrounding normal tissue. The differential effects of celecoxib on inflammation help to explain the selective protection by celecoxib of irradiated cutaneous tissues without a concurrent protection of MCa-35 tumors.

Animals↗
PubMed2004

Preliminary reliability and validity testing of a new Skin Toxicity Assessment Tool (STAT) in breast cancer patients undergoing radiotherapy.

Clear consensus on the clinical evaluation of acute skin toxicity among cancer patients undergoing radical radiotherapy (RT) is currently lacking. This study investigates the reliability and validity of a new Skin Toxicity Assessment Tool (STAT) to evaluate the objective and subjective manifestations of RT-induced acute skin effects. The STAT was designed by a multidisciplinary team involved in the management of radiation skin reactions. The tool has 3 components: patient and treatment parameters, observer scoring, and patient-reported symptoms, and was piloted in a cohort of 27 breast cancer patients by pairs of independent blinded observers. Each patient was assessed weekly during RT and 2 weeks after therapy completion. Validity and reliability testing of the STAT was performed. Information on the tool's ease of use was obtained by recording the time necessary to complete the assessment at each visit and by a survey among the tool's users. All subjects developed some degree of skin reaction during breast RT. The level of agreement between observers in eliciting subjective complaints ranged from 72% to 92% (95% CI = 63-96%; kappa = 0.33-0.68). The interobserver agreement in scoring skin reactions ranged from 65.0 to 97.5% (kappa = 0.46-0.81). Objective and subjective toxicity scores were significantly correlated (P < 0.05). The STAT was easy to use and required on average a few minutes to complete at each visit. The STAT is an easy-to-use, standardized instrument to evaluate acute skin reaction and may be applied to clinical care and research in patients undergoing radiotherapy.

Breast Neoplasms↗
PubMed2005

radiotherapy-induced ID reaction.

To the authors' knowledge, there is a paucity of published accounts of radiotherapy-induced ID reaction. We report a case of generalized dermatitis pathologically defined as an ID reaction after a course of local radiotherapy.

Anti-Inflammatory Agents↗
PubMed2005

Re-evaluation of the ultraviolet hazard action spectrum--the impact of spectral bandwidth.

The action spectra S(lambda) used for risk assessment of ultraviolet (UV) sources has been widely used since its development over three decades ago. This "UV hazard function" is cited in many safety standards, and UV survey instruments are designed to have a fitting spectral response. The UV hazard function was developed to preclude acute injury and minimize chronic effects but was based upon the best available experimental data of that time. With more experimental data and easier computer methods available today, the action spectrum can be re-examined. Therefore, the published experimental thresholds for damage to the cornea and skin were studied as a function of wavelength to revalidate this action spectrum. A key step relates to the proper consideration of the spectral bandwidth used to determine each threshold and the assignment of an effective wavelength for each narrow-band. We methodically analyzed the uncertainties introduced by employing 1-, 5-, and 10-nm spectral bandwidths by comparing published biological threshold data. The errors introduced by using broader bandwidths become enormous within the critical spectral region of 300-320 nm. By convoluting the threshold data and weighting them with trial, or reference, action spectra, it is possible to determine the wavelengths in each bandwidth that are contributing most of the effective dose and correct the experimental action spectrum. It is concluded that the current hazard function S(lambda) remains valid.

Animals↗
PubMed2006

Corneal perforation secondary to UV radiation from a tanning lamp.

PURPOSE: To report the case of a patient with keratoconus who developed a corneal perforation secondary to UV radiation from a tanning lamp. We believe this to be the first case of a corneal perforation secondary to UV radiation. METHODS: The presentation and management of the patient and the pathophysiology of UV keratitis are discussed. RESULTS: Our patient developed a full-thickness corneal perforation after 30 minutes of tanning lamp exposure without eye protection. The cornea was temporized with cyanoacrylate tissue adhesive until penetrating keratoplasty could be performed. CONCLUSION: With an increased understanding of the pathophysiology of UV damage, treatment should be aimed at modulating the disease to reduce the likelihood of a poor outcome.

Cornea↗
PubMed2006

Comparison of local recurrence and distant metastases between breast cancer patients after postmastectomy radiotherapy with and without immediate TRAM flap reconstruction.

BACKGROUND: The purpose of this study was to compare the local recurrence and distant metastasis of postmastectomy radiotherapy for breast cancer patients with and without immediate transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction. METHODS: Between March of 1997 and October of 2001, 191 breast cancer patients received postmastectomy radiotherapy: 82 patients had TRAM flap reconstruction (TRAM flap group) and 109 patients did not (non-TRAM flap group). The mean radiation dose to the chest wall or entire TRAM flap, axillary area, and lower neck was 50 Gy (range, 48 to 54 Gy). The median follow-up period was 40 months. RESULTS: The percentages of chest wall recurrence were 3.7 percent (three of 82) in the TRAM flap group and 1.8 percent (two of 109) in the non-TRAM flap group (p = 0.653). The percentages of distant metastases were 12.2 percent (10 of 82) in the TRAM group and 15.6 percent (17 of 109) for the non-TRAM group (p = 0.67). The percentages of acute radiation dermatitis according to Radiation Therapy Oncology Group scoring criteria (TRAM flap group versus non-TRAM flap group) were as follows: grade I, 74 of 82 (90 percent) versus 93 of 109 (85 percent); grade II, seven of 82 (9 percent) versus 13 of 109 (12 percent); grade III, one of 82 (1 percent) versus three of 109 (3 percent) (p = 0.558). In the TRAM flap group, the increased percentage of fat necrosis was 8 percent. No flap loss was detected. CONCLUSIONS: There were no significant differences in the incidences of complication, locoregional recurrence, and distant metastasis between the TRAM flap and non-TRAM flap patients. The authors' results suggest that immediate TRAM flap reconstruction can be considered a feasible treatment for breast cancer patients requiring postmastectomy radiotherapy.

Adult↗
PubMed2006

Structural fat grafting: more than a permanent filler.

Grafted fat has many attributes of an ideal filler, but the results, like those of any procedure, are technique dependent. Fat grafting remains shrouded in the stigma of variable results experienced by most plastic surgeons when they first graft fat. However, many who originally reported failure eventually report success after altering their methods of harvesting, refinement, and placement. Many surgeons have refined their techniques to obtain long-term survival and volume replacement with grafted fat. They have observed that transplanted fat not only adjusts facial and body proportion but also improves surrounding tissues into which the fat is placed. They have noted not only the improvement in the quality of aging skin and scars but also a remarkable improvement in conditions such as radiation damage, chronic ulceration, breast capsular contracture, and damaged vocal cords. The mechanism of fat graft survival is not clear, and the role of adipose-derived stem cells and preadipocytes in fat survival remains to be determined. Early research has indicated the possible involvement of more undifferentiated cells in some of the observed effects of fat grafting on surrounding tissues. Of particular interest is the research that has pointed to the use of stem cells to repair and even to become bone, cartilage, muscle, blood vessels, nerves, and skin. Further studies are essential to understand grafted fat tissue.

Acne Vulgaris↗
PubMed2004

Consequences of radiation accidents.

Radiation injury attributable to radiotherapy is a topic that has attracted ample attention in the literature, especially in a vast number of publications in plastic surgery. However, the literature is clearly devoid of compilations regarding the effects of ionized radiation accidents. A case of a radiation accident is presented. It is nearly impossible to anticipate the extent of effects of external irradiation of the skin and subcutaneous tissues. The initially healed area should be expected to show late recurrent necrosis. Patients exposed to ionized external irradiation are no longer radioactive and can be treated as ordinary patients. However, these patients should be followed closely for years, keeping in mind the onset of late radiation effects like skin necrosis in various parts of the body, skin and other organ cancers, leukemia, infertility, hypothyroidism, and cataracts.

Adult↗
PubMed2004

Skin toxicity during breast irradiation: pathophysiology and management.

Radiotherapy is a critical component in the treatment of breast cancer, a disease that is estimated to have affected 203,500 US women in 2002. According to the data from some series, an estimated 90% of patients treated with radiotherapy for breast cancer will develop a degree of radiation-induced dermatitis. This review describes the indications and techniques of radiotherapy for breast cancer. The pathophysiology, clinical presentation, and contributing factors of radiation-related skin injury are discussed. A review of recent clinical research addressing skin toxicity is provided.

Breast Neoplasms↗
PubMed1994

Expression of 72-kDa gelatinase (MMP-2), collagenase (MMP-1), and tissue metalloproteinase inhibitor (TIMP) in primary pig skin fibroblast cultures derived from radiation-induced skin fibrosis.

In addition to producing matrix degradation for normal tissue remodeling and repair, matrix metalloproteinases (MMPs) are also involved in various pathologic processes. MMPs and the tissue inhibitor of MMPs (TIMP) were investigated in primary cultures of pig fibroblasts from radiation-induced dermal fibrosis and compared to normal dermal fibroblasts. The free gelatinolytic, collagenolytic, and caseinolytic activities secreted into the culture medium were evaluated against specific 3H denatured collagen type I, native helical collagen, and casein alpha, respectively. The 72- and 68-kilodalton (kDa) forms of type IV collagenase were investigated by protease zymography and quantified by semi-automated image analysis. Transcription of the interstitial collagenase (MMP-1) and TIMP genes was studied by Northern hybridization analysis. Results revealed that in fibrotic fibroblasts, the amount of MMP-1 mRNA was greatly reduced to undetectable levels whereas the amount of TIMP mRNA was increased fourfold compared to controls. Functional assays using specific 3H substrates demonstrated an overall decrease in free MMP activities. Concomitantly, catheptic collagenolytic activity decreased in fibrotic fibroblast extracts compared to controls. These results indicate that in addition to accumulating large amounts of collagen, proteoglycans, and fibronectin, pig fibroblasts from radiation-induced dermal fibrosis also promote connective tissue matrix formation by repressing MMP-1 and stimulating TIMP expression at the transcriptional level, and by reducing overall free MMP and catheptic collagenolytic activities at the post-transcriptional level. In contrast, enzymography assays and automated image analysis demonstrated no significant change in the 72-kDa type IV collagenase activity of fibrotic pig skin fibroblasts. This opposite regulation of 72-kDa collagenase type IV to that of MMP-1 seems to indicate that it has a specific role in remodeling the extracellular matrix during wound healing, fibrogenesis, and angiogenesis.

Animals↗