Radiation-induced malignant fibrous histiocytoma of the occipital: a case report.

Malignant fibrous histiocytoma (MFH) is a rare neoplasm exhibiting a propensity for aggressive clinical behavior. Effective treatment modality is surgical resection with wide margins, but its rate of recurrence and metastasis is still high. Early detection and complete excision of the tumor is necessary. A MFH of the occipital developed in a 51-year-old woman eight years after surgery and radiation for medulloblastoma of the cerebellar vermis. The secondary neoplasm arose at the site of tumor resection within the irradiated field, and was resected. The development of sarcomas is a recognized complication of radiation therapy. The final diagnosis after the operation was MFH. Radiation-induced sarcoma (RIS) is well known, but radiation-induced MFH is relatively rare in the head and neck region, especially in the occipital. The imaging findings are not diagnosis specific, but strict follow-up within the radiation field by computerized tomography (CT) and magnetic resonance imaging (MRI) and appreciation of the expected latency period may help in providing the diagnosis of RIS.

Radiation exposure to critical organs in panoramic dental examination.

Nowadays, radiography is a necessary procedure in diagnosis and treatment of patients with dental problems. According to the ALARA (as low as reasonably achievable) principle, dentists must take radiographs of sufficient quality at the lowest possible radiation dose to the patients. The assessment of patient dose on panoramic radiography is difficult because of dynamic nature of the imaging process and the narrow width of the x-ray beam. The present work describes an experiment undertaken using thermoluminescence dosimeters (TLD-100) to obtain the absorbed dose in organs and sensitive tissues in head and neck region during panoramic radiography, based on patient measurement. The overall mean entrance surface dose on thyroid, right and left lens of eyes, parotid glands (right and left) and occipital region in panoramic were 38, negligible, negligible, 367, 319 and 262 µGy, respectively. The results show that there are differences between patient doses examined by different panoramic systems. There is a tendency for lower organ doses for digital compared with analogue panoramic units.

Radiation-induced craniofacial bone growth inhibition: development of an animal model.

Craniofacial deformities caused by therapeutic radiation-induced bone growth inhibition can occur in up to 100% of survivors of childhood head and neck cancers. The mechanism of radiation-induced craniofacial bone growth inhibition is poorly understood. The objective of this study is to establish a model of radiation-induced craniofacial bone growth inhibition to study the pathophysiology of radiation on growing membranous bone. Seven-week-old male New Zealand white rabbits were randomized into 4 groups (n = 10/group) and received a single dose of orthovoltage radiation (0, 15, 25, or 35 Gy) to the right orbital-zygomatic complex. Serial radiographs and computed tomography scans were performed for cephalometric analysis, bone volume, and bone density measurements until skeletal maturity at 21 weeks. Statistically significant ( P < 0.05) reductions in orbital-zygomatic complex linear bone growth, bone volume, and bone density were found after radiation with 25 or 35 Gy compared with nonirradiated control animals. A significant ( P < 0.05) decrease in orbital-zygomatic complex volume was noted after 15-Gy radiation but there were no significant effects on linear bone growth as assessed by cephalometric analysis at this dose. This study establishes the rabbit orbital-zygomatic complex as a suitable model for the study of radiation-induced craniofacial bone growth inhibition and will permit investigation into the underlying cellular and molecular basis of this injury.

Local vasodilator response to mobile phones.

OBJECTIVES: The use of mobile phones with the resulting generation of potentially harmful electromagnetic fields (EMF) is the focus of public interest. Heat generation and the activation of the inducible form of nitric oxide (NO) synthase may be possible causes of the biological effects of EMF exposure. We investigated if a mobile telephone conversation can modify skin temperature, NO, and nasal resistance. METHODS: We studied the effect of an EMF (900 MHz) generated by a commercially available cellular phone during a 30-minute telephone conversation on skin temperature, nasal NO measured by chemiluminescence, and nasal minimal cross-sectional area (MCA) measured by rhinometry. Eleven normal subjects (mean age +/- standard error of mean [SEM], 32 +/- 5 y; 10 male) were studied. RESULTS: There was a similar and significant increase in skin temperature of the nostril and occipital area on the same side as the telephone (maximal increase 2.3 +/- 0.2 degrees C at 6 min) as well as a tendency for higher nasal NO levels (maximal increase 12.9 +/- 4.9% at 10 min), whereas the MCA was significantly reduced (maximal decrease -27 +/- 6% at 15 min). Such changes were not recorded when an earpiece was used to avoid the direct exposure to the electromagnetic field. There were no changes in the skin temperature and nasal NO measured on the opposite side to the mobile phone, whereas the MCA was significantly increased (38 +/- 10%). CONCLUSIONS: Exposure to EMF produced by a mobile phone produces biological effects that can be easily measured. Microwaves may increase skin temperature and therefore cause vasodilation and reduce MCA. Further studies are needed to study the long-term effects of mobile phone use and the relation among NO production, vasodilation, and temperature.

[Restoration of an occipital cerebrospinal fluid fistula following roentgen injury]. / Zur Sanierung der okzipitalen Liquorfistel nach Röntgenschaden.

After intensive radiation treatment following resection of a cerebellar tumor, necrosis of the occipital bone led to a chronic cerebrospinal fluid fistula. Because of eventual complications (constant loss of cerebrospinal fluid, meningitis, herniation of the brain) the chronic cerebrospinal fluid fistula needs to be treated as soon as possible. The treatment includes radical resection of the necrotic tissue, direct closure of the cerebrospinal leakage and stable soft tissue coverage. In the case presented closure was achieved with a free autologous fascia graft, cover with a myocutaneous trapezius island flap.