[Physiologic origin of skin damage and systemic symptoms caused by visual display screens?].
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Radiopreventive and radiotherapeutic efficacy of nuclyderm-gel was studied on tails of mice exposed to fractionated gamma-radiation of 90 Gy (15 + 30 + 45 Gy) and 75 Gy (45 + 30 Gy). Daily seven-day treatment with nuclyderm-gel prior to irradiation with increasing doses (15 + 30 + 45 Gy) and the subsequent continuous therapy were shown to delay and reduce skin reactions. Nuclyderm-gel was particularly effective when used therapeutically. The treatment of exposed areas, with the three-fold dose fractionation, was the optimum therapy scheme.
Tissular and cellular radiation-induced injuries. The authors examine morphological, tissular and cellular radiation-induced injuries utilizing anatomo-clinical case reports and experiments in the pig. One must distinguish early and delayed tissular lesions. In the latter, appearing in general after at least six months, vasculo-connective changes are the most important, leading to sclerosis. Indeed, because of the vascular damages the histo-haematic barrier is enlarged leading to a decrease of tissular resistance to injury, long and difficult tissular repairs after a surgical operation. At the end the authors mention some special morphological features concerning the site of lesions.
A high activity of combutec 2, prepared on the basis of soluble collagen, was demonstrated in patients with radiation injuries of the skin after the accident at Chernobyl. Combutec 2 can be recommended for local therapy of patients with skin radiation injuries in all periods of development of these changes.
The paper is devoted to a study of acute radiation reactions of the depilated thigh skin of outbred rats after their irradiation at various doses with gamma quanta and neutrons of a BR-10 reactor with the mean energy of 0.85 MeV. A scale, developed for the assessment of a degree of severity of radiation reactions permitted quantitative interpretation of the obtained results. The RBE of neutron irradiation was 4.2.
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Reactions of the laryngeal and neck skin mucosa were studied in 93 laryngeal cancer patients on combined therapy including hyperthermia. Patients in the control groups received no local hyperthermia. Reactions on the laryngeal mucosa (hyperemia, insular and confluent epitheliitis) were observed in all the patients; in patients receiving chemotherapy they were more noticeable. In patients receiving local hyperthermia these reactions appeared somewhat later and were less noticeable and not repeated. Skin reactions correlated only with a radiation dose and did not depend on chemotherapy and hyperthermia. Local electromagnetic hyperthermia in laryngeal cancer patients neither influenced the appearance of radiation reactions nor enhanced them.
Multiple actinic keratoses occurred on skin regions that were not exposed to the sun in one (0.15%) of 672 psoriasis patients receiving long term PUVA treatment after receiving a cumulative UVA dose of 883 J/cm2. Apart from skin type II, no risk factors were found. Besides clinical signs of chronic, light-induced skin damage, there were minor indications of epidermal dystrophy. Acantholysis was abnormally common in the regions affected by actinic keratosis.
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Between May 1985 and July 1987, 49 skin reactions of 43 patients treated by proton irradiation were observed at the Particle Radiation Medical Science Center (PARMS), The University of Tsukuba. Taking the peak skin score as an endpoint, the radiobiological effects [relative biological effectiveness (RBE) and time-dose relationships] of the proton beam in multi-fractionated treatments were estimated. Factors influencing the skin dose, such as the prescribed tumor dose, tumor site, and number of applied fields, were also analyzed. The following conclusions regarding acute skin reactions to the clinical use of proton irradiation were obtained: 1) the physical skin-sparing effect of proton irradiation in single-field irradiation, especially in superficial regions, is not large compared with that of high-energy photon irradiation; 2) multidirectional proton irradiation significantly reduced the skin dose and severity of acute reactions; 3) the radiobiological effects of the proton beam, RBE and the time factor, estimated in human skin in multi-fractional treatment were slightly smaller than those of X-rays, i.e., 0.92 and -0.25 +/- 0.09, respectively.
A 70-year-old white man developed 7 eccrine poromas in an area of chronic radiation dermatitis of his right lower extremity over a period of 37 years. To our knowledge, multiple eccrine poromas unequivocally linked to chronic X-ray damage are hitherto unreported.
Defects of the chest wall after radiation for carcinoma of the breast cannot be closed by means of simple split-skin graft or compound flaps because of the decreased blood supply. Only transposition flaps will survive because of their own vascularisation. Musculocutaneous flaps, the latissimus island flap or the vertical or transverse rectus abdominis-flap, which also can be used for the reconstruction of a bid pendolous breast, are the safest.
The authors have reviewed the medical files of 100 patients with locally advanced breast cancer (Stage III), who were treated in the Department of Surgery at the Institut Jules Bordet between 1974 and 1988. All patients received pre-operative radiotherapy (average total dose 45 Gy), which was associated with chemotherapy in 74% of patients. All patients were subsequently subjected to surgery, using a modified mastectomy in 92% of cases. Our data reveal an incidence of 25% local wound infection, 34% delayed wound healing, 63% seroma formation and 22% lymphoedema of the upper limb. It seems that local postoperative morbidity is increased in patients pre-operatively irradiated. This indicates that pre-operative chemotherapy may be preferable in these patients to minimize the local postoperative morbidity and its impact on the quality of life.
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The paper is concerned with the results of investigation of antitumor effectiveness (rats, sarcoma M-1) of neutron radiation of a BR-10 reactor with the mean energy of 0.85 MeV, correlated with the effect of 60Co gamma radiation (Luch-1). RBE in single local tumor radiation with neutrons was 4.5, being higher than RBE based on acute skin radiation reactions over a tumor (4.0). For this case FTA is over I (1.13) but slightly lower than after dose fractionated irradiation (1.18). Experimental data indicate the necessity of extending the clinical use of reactor neutrons and a profound study of the effects after neutron irradiation, particularly in dose-fractionated regimens.
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