[Evaluation of late radiation-induced changes in superficial microcirculation after acute beta-irradiation. II. Prognostic importance of cutaneous Doppler laser]

Laser Doppler imaging of skin microcirculation under fiber-reinforced composite framework of facial prosthesis

OBJECTIVE

Glass-fiber reinforced composite has been suggested to be used as framework material in silicone elastomer facial prostheses. The glass-fiber reinforced framework makes it possible to make the margin of the prosthesis very tight, so that it will lean tightly against the skin even during facial expressions and jaw movements. The purpose of this study was to study how the compression of the glass-fiber reinforced framework would affect the microcirculation of the facial skin.

MATERIALS AND METHODS

A face mask, with a compression pad corresponding to the outer margin of a glass fiber-reinforced composite framework beam of a facial prosthesis, was used to apply pressure on the facial skin of healthy volunteers. The skin blood flow during touch, light and moderate compression of the skin was measured by laser Doppler imaging technique.

RESULTS

None of the compressions had any marked effects on local skin blood flow. No significant differences between the blood flow of the compressed skin, compared to the baseline values, were found.

CONCLUSIONS

The pressure applied to the skin by the tight margins of a facial prosthesis, fabricated with a framework of glass-fiber reinforced composite, does not remarkably alter the skin blood flow.

MRI assessment of local acute radiation syndrome

OBJECTIVES

To describe local acute radiation syndrome and its radiological imaging characteristics.

METHODS

We performed a retrospective study of patients who had suffered skin and deeper radiation damage who were investigated by magnetic resonance imaging (MRI). We compared the clinical findings, C-reactive protein (CRP) levels and MRI results.

RESULTS

A total of 22 MRI examinations were performed between 2005 and 2010 in 7 patients; 6 patients had increased CRP levels and MRI abnormalities. They were treated by surgery and local cellular therapy. One patient had no CRP or MRI abnormalities, and had a spontaneous good outcome. Eighteen abnormal MR examinations demonstrated high STIR signal and/or abnormal enhancement in the dermis and muscle tissues. Three MRI examinations demonstrated skeletal abnormalities, consistent with radionecrosis. The four normal MRI examinations were associated only with minor clinical manifestations such as pain and pigmentation disorders.

CONCLUSION

MRI seems to be a useful and promising imaging investigation in radiation burns management i.e. initial lesion evaluation, treatment evaluation and complication diagnosis. MRI findings correlated perfectly with clinical stage and no false negative examinations were obtained. In particular, the association between normal MRI and low CRP level seems to be related to good outcome without specific treatment.

KEY POINTS

Local acute radiation syndrome (radioepidermitis) mainly affects the skin and superficial tissues. MRI findings correspond with clinical stage (with a strong negative predictive value). MRI outperformed X-ray examination for the diagnosis of bone radionecrosis. Diffusion-weighted imaging shows low ADC in bone and soft tissue necrosis. Perfusion sequence allows assessment of tissue microcirculation impairment.

Noninvasive radiation burn diagnosis using speckle phenomenon with a fractal approach to processing

Radiation burns account for the vast majority of damage by accidental radiation exposure. They are characterized by successive and unpredictable inflammatory bursts that are preceded by a clinically latent postirradiation period. Diagnosis and prognosis of the clinical course of radiation burns have proven to be a difficult task. In a classical clinical setting, no technique can distinguish irradiated versus healthy skin during the clinically latent period, hence development of new tools is required. This work describes a noninvasive technique based on speckle phenomenon, designed to support radiation burn diagnosis and prognosis. Speckle produced by strongly scattering media contains information about their optical properties. The difficulty is to extract significant information from speckle patterns to discriminate between strongly scattering media and to characterize any change. Speckle patterns from irradiated and nonirradiated porcine skins are recorded in vivo several times after radiation exposure. A fractal approach is used in the treatment of speckle patterns. The results show that this technique allows discrimination between healthy and irradiated skin, in particular during the clinically latent period (p<0.01). Parameters extracted from speckle patterns discriminate and vary differently with radiation, which means they represent different information about skin changes.

PCC-FISH in Skin Fibroblasts for Local Dose Assessment: Biodosimetric Analysis of a Victim of the Georgian Radiological Accident

We propose a new method of biodosimetry that could be applied in cases of localized irradiation. The approach is based on excess chromosome segments determination by the PCC-FISH technique in fibroblasts isolated from skin biopsy. Typically, 0 to 10 Gy ex vivo gamma-irradiated human skin biopsies were dissociated and fibroblasts were isolated and grown for several days. Cells next underwent PCC-FISH painting of whole chromosome 4, and the number of excess chromosome segments per metaphase was determined. An ex vivo reference curve correlating the number of excess chromosome segments per metaphase to the radiation dose was established and used to assess the dose delivered to the skin of one of the victims of the radiological accident that occurred at Lia in Georgia in December 2001. Specifically, the victim suffering from moist desquamation underwent skin excision in Hospital Percy (France). Measurement of excess chromosome segments per metaphase was done in fibroblasts isolated and grown from removed wounded skin and subsequent conversion to radiation doses was performed. The radiation dose map obtained was shown to be in accordance with clinical data and physical dosimetry as well as with conventional biodosimetry. These results demonstrated that PCC-FISH painting applied to skin fibroblasts may be a suitable technique for dose estimation. To assess its worth, this approach needs to be extended to future accidents involving localized radiation exposure.