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[Morphologic study of tissue basophils of the skin in rats after acute local irradiation].

A comparative morphological study was made of tissue basophils (TB) of rat skin at remote times (40, 70, 140, and 360 days) following single local exposure to soft and hard X-radiation with the doses at the skin surface of 15, 20, and 30 Gy. The TB response was maximum in the subepidermal and supramuscular layers of friable connective tissue. Changes in a median TB diameter were of a phase nature and a function of radiation dose absorbed in the skin layers under study.

Acute Disease↗

[Spreading pigmented actinic keratosis--diagnosis and therapy].

Spreading pigmented actinic kereatosis is a rarely described premalignant epidermal lesion occurring on the skin following exposure to the sun. On clinical examination it may be difficult to distinguish it from pigmented seborrheic keratosis or lentigo maligna. Spreading growth and a diameter greater than 1.5 cm are characteristic features. We report a case of spreading pigmented actinic keratosis in a 61-year-old patient.

Facial Neoplasms↗

Proton therapy in Japan.

There are two facilities for clinical trials with protons in Japan: the National Institute of Radiological Sciences (NIRS), Chiba, and the Particle Radiation Medical Science Center (PARMS), University of Tsukuba. At the National Institute of Radiological Sciences, patient treatment with the 70 MeV proton beam began in November 1979, and 29 patients were treated through December 1984. Of 11 patients who received protons only, 9 have had local control of the tumor. Two of the 9 patients, suffering from recurrent tumor after radical photon beam irradiation, developed complications after proton treatment. In the patients treated with photons or neutrons followed by proton boost, tumors were controlled in 12 of 18 patients (66.6%), and no complications were observed in this series. Malignant melanoma could not be controlled with the proton beam. A spot-beam-scanning system for protons has been effectively used in the clinical trials to minimize the dose to the normal tissues and to concentrate the dose in the target volume. At the Particle Radiation Medical Science Center, University of Tsukuba, treatment with a vertical 250 MeV proton beam was begun in April 1983, and 22 patients were treated through February 1984. Local control of the tumor was observed in 14 of 22 patients (63.6%), whereas there was no local control in the treatment of glioblastoma multiforme. There have been no severe complications in patients treated at PARMS. The results suggest that local control of tumors will be better with proton beams than with photon beams, whereas additional modalities are required to manage radioresistant tumors.

Adult↗

[Plastic surgery reconstruction following irradiation].

Radiation damage after combined tumor therapy may involve skin, subcutaneous tissue, nerves, bones and viscera. Ulceration and subsequent infection can result in life-threatening conditions. Early reconstructive procedures restore function, prevent further damage and alleviate pain. Plastic surgery has developed special fasciocutaneous and musculocutaneous flaps for each region.

Extremities↗

[Surgical treatment of some "historical" x-ray dermatites (author's transl)].

Six cases are presented: two degenerated and four necrotic X-ray dermatitis. Four patients had received X-ray therapy for benign lesions. All suffered long standing X-ray dermatitis lasting up to 60 years. The princip of treatment is a complete excision of the diseased skin and the covering of the defect with flaps. Such severe cases which need a complex treatment, must be handled with caution. X-ray therapy is a powerful but dangerous tool; its dangers are often known late; it should be reserved for severe conditions.

Adult↗