Radiation-induced renovascular hypertension successfully treated with transluminal angioplasty: Case report

Severe hypertension and stenosis of the right renal artery developed in a 21 year old male, 14 years after completion of inverted Y radiation (4000 rads) for abdominal Hodgkin's disease. Transluminal angioplasty resulted in improvement of the right kidney function, and normalization of the blood pressure for one year. Subsequently, the patient required only minimum medical therapy for blood pressure control. Transluminal angioplasty may be effective immediately in the treatment of radiation induced renal artery stenosis, although long term success remains uncertain.     

全身放射损伤影响皮肤创伤愈合的剂量效应研究

目的 探讨全身不同剂量照射对皮肤软组织创伤愈合的剂量效应关系。方法 用^60Coγ射线一次性均匀照射1－8Gy，照后1h内，用特制的圆孔刀致大鼠背部全层皮肤φ22mm创面2个（占体表面积的2．5％）。结果 创伤合并0、1、2、3、4、5、6、7、8Gy全身照射后，随照射剂量增加，创伤愈合速度明显减缓，残留面积明显增大，如伤后7d，单创组有33.5%的创面未愈合，复合伤组分别有35．4％，38．1％，41．6％，48．8％，53．9％，63．7％，69．2％，73．9％的创面未愈合。统计学显示，伤后不同剂量与未愈合创面％（Y^)间有明显的剂量效应关系。据此推导出9个剂量效应公式。这些结果主要为群体判估放创复合伤伤情发展提供了重要基础数据。结论 放创复合伤时创伤愈合延迟有明显的剂量效应关系。     

Pelvic silicone prosthesis for prevention of radiation enteritis: US and CT features

A patient with a pelvic silicone prosthesis is presented. The sonographic and computed tomographic features in such patients can be confusing and incorrectly interpreted unless the radiologist knows that the prosthesis had been inserted as a radioprotective device. Received: 3 October 1995/Accepted: 25 October 1995     

A survey of radiation synovectomy in Europe, 1991–1993

The prevalence of radiation synovectomy practice is unknown. As new particulate radiopharmaceuticals offering many potential advantages are being developed, it seems prudent to appraise the extent, frequency and variation in radiation synovectomy practice. We have evaluated radiation synovectomy practice in Europe over the period 1991–1993 by means of a postal questionnaire. More than 2300 European members of the European Association of Nuclear Medicine were questioned about the number of treated patients and joints, disease prevalence in their patients and the use of radio-pharmaceuticals. Overall, 119/490 (24%) of centres replying to the survey practised radiation synovectomy during the 3 years. There were 13 450 different joint injections in 8578 patients. Rheumatoid arthritis was the most prevalent disease in patients treated (71%) and the most frequently treated joints were knee (46%) and finger joints (20%). Eight different radiopharmaceuticals were employed. Yttrium-90 colloids were most frequently and widely (100/119 centres) used, mainly employed for knee synovectomy but were also used to treat most appendicular joints. Erbium-169 colloid was almost exclusively used to treat finger joints (31/33 centres). Corticosteroid was routinely co-injected in 36/60 (60%) centres. Radiation synovectomy was widely practised throughout Europe during 1991–1993. There are variations in practice illustrated by the diversity of treated arthritides and injected joints and by the use and application of different radiopharmaceuticals.     

电离辐射诱发的联会复合体畸变研究

以雄性昆明种小鼠为实验材料，Ｘ射线一次全身均匀照射，照后不同时间取材，分别用电子显微镜观察精母细胞前期联会复合体畸变和光镜观察中期Ⅰ染色体畸变。结果表明，和中期Ⅰ染色体畸变相比，联会复合体的畸变类型更复杂，其发生频率也明显增高；回归分析表明，两者多价体发生率均随剂量增加而增加，剂量与多价体发生率之间的关系符合直线方程，Ｙｓｃ＝－０．８６＋１．６８Ｄ（ｒ＝０．９３）ＹＤ－ＭＩ＝－０．２０＋０．９０Ｄ（ｒ＝０．９９），说明联会复合体分析可以更敏感地检测畸变。因此，利用联会复合体检测技术来估价电离辐射对哺乳动物潜在的遗传危害优于常规染色体畸变分析。     

60Co-γ射线照射对大鼠肺一氧化氮合酶和内皮素系统基因表达的影响

目的 探讨一氧化氮合酶（ｎｉｔｒｉｃ ｏｘｉｄｅ ｓｙｎｔｈａｓｅ，ＮＯＳ）和内皮素（ｅｎｄｏｔｈｅｌｉｎ，ＥＴ）及ＥＴ转换酶（ｅｎｄｏｔｈｅｌｉｎ ｃｏｎｖｅｒｔｉｎｇ ｅｎｚｙｍｅ，ＥＣＥ）等在受照射肺中的基因表达变化，揭示其在肺纤维化发生中的参与作用。方法 用＾６０Ｃｏ对大鼠肺进行３０Ｇｙ照射，照后４，８，２４天提取总ＲＮＡ，分别做ＲＴ－ＰＣＲ；对照射后１，３，５个月肺组织进行ＥＴ肽的Ｗｅｓ     

The use of a partial transmission shield to reduce the optic chiasm doses during radiation therapy treatment of brain tumors

Historically, brain tumors have been treated with lateral opposed beams for 40–45 Gy followed by more conformal reduced fields. Advances in treatment planning computers have led to the implementation of conformal non-axial techniques, allowing for escalation of dose. In patients where total doses exceed 50 Gy, adjacent critical structures can be protected with a partially shielded transmission block over the optic nerves and chiasm. By eliminating the conedown portion of the treatment a more cost and time effective treatment is achieved. Partially shielded blocks can be designed by using cerrobend or multileaf collimation. They can be included in the treatment plan and verified by an irregular field calculation and/or thermoluminescent dosimeters.     

The impact of surgical margin status and use of an interstitial implant on T1,T2 oral tongue cancers after surgery

In patients with T1, T2 oral tongue carcinoma treated with surgical resection, postoperative radiation therapy (RT) is required especially when surgical margins contain tumors. Irradiation techniques include external beam, interstitial implants, or a combination of the two modalities. We investigated whether positive surgical margin remains a poor prognostic factor after radiation therapy, and the contribution of interstitial implants to disease control.

Between 1972 and 1989, 55 patients were treated postoperatively at the Mallinckrodt Institute of Radiology for T1, T2 squamous cell carcinomas of the oral tongue. Surgeries included 26 wide excisions or excisional biopsies and 29 composite resections or hemiglossectomies. Thirty-nine patients received external radiation therapy alone and 16 patients had an interstitial implant (ISI) as part of the treatment. The minimum follow-up is 4 years.

At 2 and 5 years, the overall survivals for all patients were 82 and 68%. The disease-free survivals (DFS) were 82 and 70%, respectively. There was no significant difference in the pattern of failure and DFS when stratified by the status of surgical margins and the type of the surgical procedure. Local control was achieved in 15 of 18 patients when surgical margins were involved by tumor and in 29 of 37 patients without tumor involving margins (p = 0.05). Ten of 18 (56%) patients with tumor involving resection margins were treated with ISI, whereas only 3 or 33 (9%) of those with negative margins received ISI. Local control was achieved in 32 of 39 patients treated with external beam RT alone, and 13 of 16 patients who received interstitial implant (p = 0.05). Four patients treated with ISI developed persistent soft tissue ulceration and mandibular bone exposure.

Postoperative radiation therapy converted the ominous outcome of patients with tumor involving surgical margins. Patients with positive surgical margins were often selected to be treated with interstitial implants. We found that the local control was as good as in those with a more favorable pathology (negative margins) and treated with external RT alone. Further investigation is needed to optimize the implant treatment to minimize the complications.     

人放射性皮肤溃疡c－erbB－2、EGFR蛋白高表达病理研究

我们应用ｃ－ｅｒｂＢ－２、ＥＧＦＲ蛋白抗体和微波炉抗原修复法对２５例人放射性皮肤溃疡进行免疫组织化学研究。结果发现ｃ－ｅｒｂＢ－２癌蛋白高表达阳性率为９２．０％（２３／２５），ＥＧＦＲ蛋白高表达阳性率为７３．７％（１４／１９）；二者阳性部位一致，主要见于鳞状上皮细胞膜、间质纤维母细胞、血管内皮细胞以及小动脉中层平滑肌细胞和外层纤维细胞胞质，提示ｃ－ｅｒｂＢ－２、ＥＧＦＲ蛋白的高表达可能与放射性皮肤溃疡的癌变和难以愈合有关。     

放射及复合烧伤大鼠腹腔灌洗液对骨髓造血祖细胞生长的影响

目的　观察放射损伤、烧伤及放烧复合伤腹腔灌洗液对骨髓体外造血的影响。方法60 Coγ射线全身照射 1 2Gy、5kW溴钨灯致大鼠背部 30 %TBSAⅢ度烧伤。伤后 3 ,1 2 ,2 4 ,48和 72h无菌抽取腹腔灌洗液 ,按 40 μg ml加入到骨髓红系、粒系培养体系中培养。 结果　伤后 3 ,1 2 ,2 4 ,48和72h,烧伤组和复合伤组的CFU E、BFU E和CFU GM培养集落数均显著高于正常对照组 (P <0 0 1 ) ,且以伤后 2 4h最高 ,烧伤组高达 2 1 5 7%、2 0 2 3 %和 2 4 1 2 % ,复合伤组为 1 88 1 %、1 4 7 7%和2 0 4 6 %。但当加入放射损伤大鼠腹腔灌洗液时 ,仅有很少的CFU E、BFU E和CFU GM集落生长。结论　烧伤与放烧复合伤后的腹腔灌洗液对骨髓红系、粒系造血均有明显的促进作用 ,照射组则显示明显的抑制作用