Index

Absorption, radiation, 4-5, 85-86 Absorption coefficient, ultrasound,

263, 266 Acne

cryosurgery for, 273-74 phototherapy for, 241 radiotherapy for, 60, 159, 170

Acoustic holography, 249 Acoustic impedance, ultrasound, 264 Actinic keratoses

cryosurgery for, 272-73 elcctrosu rgery for, 220 offace, 178, 179 of hand, 180 grenz-ray therapy for. 177

Actinomycin D, radiotherapy and, 33, 35

Acupuncture, lasers for, 255 Aerokromayer lamp, 237, 238, 241 Alopecia

phototherapy for, 241-42 radiotherapy and, 96. 1l3, 164-65

Alternating current, 188-89 characteristics and uses of, in

medicine, 204 electrosurgery and, 203-26 for epilation, 197, 198 ultrasound and, 265

Aluminum as x-ray beam filter, 66-67 American Board of Dermatology, 92 Aminocaproic acid for erythema, 50 S-2-(3-Aminopropylamino)cthyl-

phosphorothioic acid, 50 Amperes, amperemeters, ammeters,

and amperage, 187 Anesthesia

electrocautery and. 200-201 electrosurgery and, 215, 216, 218

laser surgery and, 253 nerve block, digital, 218

Angiokeratoma, scrotal, x-ray therapy and, 177

Angiomas electrosurgery for, 216 laser surgery for, 252-53

Anhidrosis, galvanism and, 196 Anoxia, 24. 25 Apocrine glands, Paget's disease and,

224-25 Arc light sources. 228, 229 Arc plasma scalpel, 257 Argon-·helium plasma torch, 258,

259 Argon laser. 246, 252, 253, 255 Arm

carcinoma of. 183 lentigo maligna of. 126, 131

Atopic dermatitis. grenz-ray therapy for, 183

Atrophy from radiotherapy, 51

grenz rays and, 176 electrosurgery for, 225

Attenuation coefficient, 6, 13

Backscatter, 9-11 ultrasoft x rays and, 164

Basal cell carcinoma, 95-114, 144 of arm, 183 cryosurgery for, 272, 275-76. 277,

279 of ear. 103-6 electrosurgery for, 186, 223 of eye. 97-101 of lip. 106-8 of nose, 101--3

radiotherapy of. 95-114. 119 schedules for. 109 superficial, 114-15 ultrasoft, 169

Basal cell epitheliomas, grenz-ray therapy for, 178-80

Basal cell malignancies. multiple. laser surgery for, 253-54

Basal cell papillomas, electrosurgery for, 219-20

Basking behavior, 236 Batteries, galvanic cun'ent and. 190 Beam divergem:e and attenuation, 12-

13 Benign diseases

cryosurgery for, 272-74 radiotherapy for, 155-59

electron hearn, 144 grenz-ray, 180-84 teleroentgen, 152-53

Beryllium-window machines, 80 calibration of. 42, 69 grenz rays and, 74, 162 kilovoltage and, 66 for lentigo maligna, 122 soft x-ray therapy with, 75 teleroentgen therapy and, 147-49

Betatrons, 87 Biopsy

electrosurgery and, 221 lentigo maligna and, 123-24

Birthmarks, electrosurgery for, 216 Blacklight. 230, 231, 233-34

high output. 231, 233-34 Black ray lamp. 231 Bleeding

after electrosurgery, 214-15.220 plasma torch and, 260

283

284 Index

Bowen's disease, 129-37 of foot and toes, 174-75, 176 of forearm, 182 radiotherapy of, 114-15, 129-37

grenz-ray, 178 ultrasoft, 169

Brass eye shields, 99, 102 Breast

carcinoma of, electron beam therapy for, 144

Paget's disease of, 224 Bremsstrahlung, 2-4

Compton electrons and, 5 homogeneity factor for, 7

Bucky rays, 74, 82 Build-up factor, radiation, 13

Calibration. See X-ray machines, calibration of.

Cancer. See also Basal cell carcinoma; Carcinoma; Squamous cell carcinoma.

delayed regression of, after radiotherapy, 113

grenz radiation causing, 55-56 half-value depth for, 69 metastasis. See Metastases. thyroid, 59-60

Canthal lesions, 98 Capillary hemangioma, ultrasoft x

rays for, 167 Carbon arc lamp, 229, 231, 240

global radiation and, 232 Carbon dioxide lasers, 245-46, 250,

255 Carbon dioxide for cryosurgery, 271 Carbonization, electrosurgery and,

208,210 Carbon monoxide laser, 246 Carcinoma. See also Basal cell

carcinoma; Metastases; Squamous cell carcinoma.

breast, 144 cryosurgery for, 272, 274-77, 279 radiation-induced, 56-59 from radiodermatitis, 114 radiotherapy of, 95-115, 119, 120

recurrent, 170-71 Strandquist curve of time-dose

relationships for, 21-22 in situ, electrosurgery for, 224-25

Cataphoresis, 193 Cataracts, radiation-induced, 61, 97 Cautery. See Electrocautery. Cavernous angiomas, laser surgery

for, 252-53 Cavernous hemangioma, ultrasoft x

rays for, 167 Cellon, 122 Cells, radiation and, 18-24

division of, 27-35 high LET and, 23-24 interphase death of, 30

kinetics of, 27-35 mixed populations and, 22-23 multiple doses and, 21-22 repair of injury and, 20-21 resting, 29 synchrony of, 27-29, 33-34

Chaoul Contact Therapy Unit, 74 Charring, electrosurgery and, 208,

210 Cheek

basal cell carcinoma of, 275 keloids of, 274 lentigo maligna of, 125, 126, 127,

130, 132 Chemosurgery, 220 Chemotherapy

dermatitis suppression by, 50-51 radiotherapy and, 33-35

Chloroquin for dermatitis suppression, 50

Chromosomes, radiation damage to, 30-31,61

Coagulation. See also Electrocoagulation; Electrosurgery .

lasers and, 247 Coal tar, psoriasis therapy and, 242 Cobalt-60 units, 86 COFFEE laser, 246 Colchicine, radiotherapy and, 33, 34 Cold, therapeutic, 185. See also

Cryosurgery. Collision loss, electron, 3, 5 Communications, laser, 249-50 Compton effect (electrons), 5,17,85-

86 Conduction, electrical, 189 Condylomata acuminata, florid, laser

surgery for, 254 Cones, radiotherapy, 39, 42 Conjunctiva

cancer of, cryosurgery for, 277 leukoplakia of, 97, 113

Contact x-ray therapy, 72, 74-75 machines for, 74-78, 81

Coolants, cryosurgical, 271 Copper, x-ray beam filtration by, 67 Cosmetic results

of electrosurgery, 186, 214, 219 of radiotherapy, 96, 113

Crusting, radiation and, 110 Cryosurgery, 270--79

for acne, 273-74 for actinic keratoses, 272-73 for benign disorders, 272-74 instrumentation, 271-72 for ke10ids, 274 for malignant tumors, 272, 274-77,

279 pathogenesis, 270-71 reflections on 13 years of, 278 refrigerants used in, 271 statistical data, 278

thermal gradients, 272 for warts, 272, 273

Curettement, electrosurgery and, 223, 224

Cysteamine, hair-cell protection by, 50

Cysts, electrosurgery for, 225 Cytofluorography, 246

Danna's method, 225 Depth dose, 9-14,67-68,70

megavoltage, 89 percentage, 11-13, 148

Dermatitis atopic, grenz-ray therapy for, 183 lichenified plaques, 166 radiation-causes, 49, 51-55. See

also Radiodermatitis. ultrasoft x rays for, 166

Dermatoses, radiotherapy of, 155-59. See also Benign diseases.

electron beam, 144 half-value depth for, 70 teleroentgen, 152-53

Dermopan equipment, 80, 118, 119 Desiccation, electrical. See

Electrodesiccation; Electrosurgery .

Diathermy, 203. See also Electrosurgery .

circuits and wave forms, 204,205 for epilation, 199 longwave, 208, 209 ultrasound, 262-63, 266

Dielectric hysteresis or loss, 207 Digitate tumors, electrosurgery for,

216 Direct current, 187-88, 190-%

for epilation, 197, 198 dermatologic uses of, 190, 191

Divergence, beam, 12 DNA, radiation and, 32-32 Dosimetry, radiation, 7-9. See also

Radiation dosimetry. Dry cell, 191

Ear basal cell carcinoma of,

radiotherapy for, 103-6 multiple malignancies involving, 254

Eczema, radiotherapy for, 158 nummular, 182-83

Edema, radiodermatitis, 52 Electricity, 185, 187-89

alternating current, 188-89, 197, 203-226. See also Alternating current.

conduction of, 189 direct current, 187-88, 190-96. See

also Direct current. plasma torch and, 258

Electrocautery, 200-202 anesthesia for, 200--201

basic circuitry, 201 galvanic current and, 190 scars after, 201-2

Electrocoagulation, 206, 208. See a/so Electrosurgery.

for basal cell cancer, 222, 223 clinical applications, 212 general procedures, 213-16 precautions, 210

Electrodes electrosurgery, 204 galvanism and, 194-95 knife, 212-13 plasma torch, 258

Electrodesiccation, 206, 208. See a/so Electrosu rgery.

clinical applications, 212 curettement and, 223, 224 general procedures, 213-16 precautions, 210 for warts, 214, 217-18

Electrofulguration,211-12 Electrolysis, 195, 197-99

galvanic current and, 190 Electromagnetic spectrum, 1, 2 Electron beam therapy, 139-44

for benign diseases, 144 for Kaposi's sarcoma, 143-44 keloids and, 144 for mycosis fungoides, 117, 140-43

Electrons Compton, 5, 17,85-86 electricity and, 187 hydrated, 18 interactions of, 3, 4-5 photoelectric absorption and, 85

Electron volts, 1 Electroosmosis, 193 Electrophoresis, 193 Electrosection,212-13 Electrosurgery, 203-26

for actinic keratoses, 220 anesthesia for, 215, 216, 218 for basal cell carcinomas, 186, 223 biopsy and, 221 bleeding after, 214-15, 220 for carcinomas in situ, 224-25 clinical applications, 211-16 cosmetic results of, 186, 214, 219 for cysts, 225 for epitheliomas, 220-24 for filiform and digitate tumors, 216 for hidradenitis suppurativa, 225 for nevi, 219, 225-26 pacemakers and, 209-10 for papillomas, 216, 219 for precancerous lesions, 224-25 precautions, 208-11 preoperative preparation, 215 for rhinophyma, 225 saucerization and, 210, 213 scarring from, 208, 214, 217, 225 for seborrheic dermatitis, 219-20

specific treatment by, 216-26 tissue effects of, 206-8 urologic, 209-10 for vascular tumors, 216 for verrucae, 216-18 voltage and frequency for, 203

Energy, equivalent, 7 Environment, radiation from, 61 Epilation, 195, 197-99 Epitheliomas

basal cell, grenz-ray therapy for, 178-80

electrosurgery for, 220-24 Equivalent energy, kilovoltage, and

wavelength, 7 Erythema

minimal perceptible, 240, 241 phototherapy, 230, 240-41 radiation (roentgen), 49, 50-51,

108-10 single dose and, 156 threshold, 157 ultraviolet, 240-41

Erythema dose, 49, 157 Erythroderma, electron beam therapy

for, 144 Erythroplasia of Queyrat, 130, 134

electrosurgery for, 224 Ethyl chloride for cryosurgery, 271 Exposure, radiation, 7-8 Extremity, upper, radiation protection

of, 44, 45 Eyelid

basal cell carcinomas of, 97-101 Bowen's disease of, 130-31, 135 classification of lesions of, canthal

vs. lid, 98 cryosurgery for cancer of, 277, 279 lentigo maligna of, 125-28 leukoplakia of, 97, 113 protection of

Face

phototherapy and, 237 radiotherapy and, 97-101

actinic keratoses of, 178, 179 radiation protection of, 44 radiodermatitis of, 53

Fall-off ratio, 14 Ferrofiuids, laser surgery and, 254 I-factor, 9, 11 Fibrosarcoma, paradoxical, 58 Fibrosis, radiation-induced, 52, 58-59 Filiform tumors, electrosurgery for,

216 Film badge, 47 Filtration, radiation, 66-67, 161, 162 Finger nails, shielding for

radiotherapy of, 45 Fluorescent blacklight, 231 Fluorescent sunlamp, 230, 231, 239-

40

Index 285

5-Fluorouracil, 220 for actinic keratoses, 273

Focus-skin distance (FSD), 65-66 Foot, radiation-induced carcinoma of,

56 Forearm, Bowen's disease of, 182 Fractionation of radiation, 21-22, 24 Freckle, melanotic (Hutchinson). See

Lentigo maligna. Freezing, therapeutic, 185. See a/so

Cryosurgery. Freon, 271 Frequencies, electromagnetic, 1,2,

188 Frigitronics, 271

Galvanic current, 187-88 batteries for, 190

Galvanic surgery, 190-96 for epilation, 197, 198

Galvanocauteries, 200 Gamma rays,S General Electric Maximar x-ray

machine, 82 Generator

spark gap, 204, 206, 212 ultrasound, 265 Van de Graaff, 139

Genetic damage by radiation, 31 Germicidal lamp, 239 Glasses

laser protective, 247-48 phototherapy, 237, 238

Glass-window machines for teleroentgen therapy, 149

Glomus tumors, laser surgery for, 253 Goeckerman regimen, 242-43 Gonads, protection of, in

radiotherapy, 44, 60-61 Gougelman shield, 98, 99, 101 G, and G2 phases of cell division, 27-

33 Granuloma, swimming pool,

radiotherapy for, 169-70 Grenz-ray therapy, 72, 73-74, 161,

173-84. See also Ultrasoft x rays.

for actinic keratoses, 177 alopecia and, 164-65 for atopic dermatitis, 183 benign changes following, 55 beryllium-window tubes for, 74, 162 for Bowen's disease, 115, 178 calibration for, 162, 164, 174 for carcinoma, 115, 178 clinical applications, 177-84 for dermatitis, 166, 183 dosage, 157, 162, 174 for eczema, nummular, 182-83 for epitheliomas, multicentric, of

trunk, 178-80 for herpes simplex. 183-84

286 Index

Grenz-ray therapy (cant.)

indications for, 91, 94 for keloids, 168-69 for keratosis follicularis, 167 for leishmaniasis, 170 for lentigo maligna, 122-23 for leukoplakia and leukokeratosis,

178 for lichen planus, 167 machines for, 73-74, 76, 77, 162-

64, 174 malignant changes following, 55-

56 for nevus flammeus, 168 photoelectric effect and, 162 pigmentation after, 174 for psoriasis, 166-67, 180-82 for seborrheic dermatitis, 167 sequelae, 176-77 shielding for, 174, 175 side effects of. 164-66 technical considerations, 161-64,

173-76 tolerance for, 156 TSDs for, 174

Hair epilation, 195, 197-99 matrix cells, radiotherapy and, 33-

34 Half-dose depth (HDD), 68, 118 Half-value depth (HVD)

for lentigo maligna, 123 treatment planning and, 68-71 for ultrasoft x rays, 164

Half-value layer (HVL), 6-7, 66 backscatter and, 11 fall-off and, 14 I-factor and, 9 grenz-ray therapy and, 74 half-dose depth and, 118 percentage depth dose and, 13

Hand actinic keratoses of, 180 shielding for radiotherapy of, 45 wart removal from, 217, 218

Head, radiation protection for, 44 Heat, therapeutic, 185, 189. See also

Electrocautery ; Electrosurgery.

lasers and, 247 ultrasound and, 262-63, 266

HeLa cells, radiation and, 18, 32 Helium-neon laser, 246, 251, 255 Hemangiomas

cavernous, ultrasoft x rays for, 167-68

electrosurgery for, 216 laser surgery for, 252-53 port-wine, 168. See also Port-wine

stain. radiotherapy for, 159

Herodotus, 237

Herpes simplex, ultrasoft x rays for, 167, 183-84

Hidradenitis suppurativa electrosurgery for, 225 radiotherapy for, 158 ultrasoft x rays for, 171

Hirsutism, radiotherapy for, 159 "Hockey stick" shields, 107, 108 Hodgkin's disease, radiotherapy for,

117 Holography, lasers and, 249 Homogeneity factor, 7 Hutchinson freckle. See Lentigo

maligna. HVL. See Half-value layer. Hydrogen radicals, 18 Hydroxyl radicals, 18 Hydroxyurea, radiotherapy and, 33 Hyperhidrosis

galvanism and, 196 radiotherapy for, 155, 159

Hyperpigmentation, x-ray therapy and. See Pigmentation.

Hypoxia, 24

Immunology, lasers and, 254 Incandescent light sources, 228, 232 Indomethacin for dermatitis

suppression, 50 Infectious skin disorders,

radiotherapy for, 158-59 Intensity of x rays, 3 Intermediate x-ray therapy, 72 International Commission on

Radiation Units and Measurements, 8

International Commission on Radiological Protection, dose limits of, 62

International Medical Research x-ray equipment, 174

International System of Units, 8 Interphase death of cells, 30 Inverse square law, 161 Ionization. See also Radiation.

chambers, 8 direct current and, 193 linear energy transfer and, 17-18,

23-24,25 Ions, transfer of, 192-96 Iontophoresis, 190, 192-96 Irradiation. See Radiation;

Radiotherapy. Isodose distributions, 14 Isolation transformers, 192 Itching, radiation and, 110

Jadassohn, nevus of, 225-26 Jaundice, neonatal, phototherapy for,

242 Jaw, keloid at angle of, 168 Jet scalpel, 257 Joule's laws, 189

Kaposi's sarcoma, radiotherapy for, 117-18

electron beam, 143-44 Keloids

cryosurgery for, 274 grenz-ray therapy for, 168-69 electron beam therapy and, 144 radiotherapy for, 159

Keratoacanthoma, radiotherapy of, 114, 119

Keratosis. See also Actinic keratoses. cryosurgery for, 272-73 follicularis, grenz-ray therapy for,

167, 177 from radiotherapy, 51 seborrheic, electrosurgery for, 219-

20 Kilovoltage, 66

equivalent, 7 lowest effective, 46-47 scatter related to, 39, 40

Kirlian chemoluminescent photography, 255

Kromayer lamp, 237 Krypton laser, 246

Laser surgery, 245-55 acupuncture and, 255 anesthesia and, 253 applications, 248-49 argon, 246, 252, 253, 255 carbon dioxide, 245-46, 250, 255 color of target area and, 247 communications and, 249-50 for condylomata acuminata, florid,

254-55 continuous wave (CW), 245, 247 diagnostic techniques and, 249-50 ferrofluids and, 254 future developments for, 255 helium-neon, 249, 251, 255 holography and, 249 immunology and, 254 investigative, 250 microirradiation and, 248 for multiple malignancies, 253-54 pulsed, 245, 247 Q-switched, 251, 252 ruby, 246, 251 safety of, 247-48 scalpel, 250 systems available for, 245-46 for tattoos, 251-52 techniques, 250-55 tissue reactions and, 247 tunable dye systems for, 246 for ulcers, chronic, 255 for vascular tumors, 252-53

Lead, radiation protection and, 39, 42-43,47

ear shields, 104-6 eye shields, 98, 99 equivalent, 48

lip shields, 106-7 MPD and, 41 nose shields, 101-3 thickness for, 43

Lead poisoning, laser analysis and, 248

Leduc's experiment, 194 Leishmaniasis, grenz-ray therapy for,

170 Lentigo maligna, 122-29

age distribution of, 124-25 case reports of, 125-29 differential diagnosis, 123-24 laser surgery for, 254 radiotherapy of, 122-29, 169

Lethal dose, radiation, 18 Leukokeratosis

grenz-ray therapy for, 178 of lip, 178, 180

Leukoplakia conjunctival, 97, 113 electrosurgery for, 225 grenz-ray therapy for, 178 of lip, 178, 180

Lichenification, radiotherapy for, 159 Lichen planus, radiotherapy for, 138

grenz-ray, 167 Light therapy, See Phototherapy, Lindemann window, 74 Linear accclerators, 86-87, 139-40 Linear energy transfer (LET), 17-18,

23-24,25 Linear hypothesis, 59 Lip

carcinoma of, 106-8,276,277, 279 leukoplakia and leukokeratoses of,

178, 180 mucositis of, 106, 11 0 port -wine stain of, 253 radiotherapy of, 106-8

Liquid nitrogen for cryosurgery, 270-74

Lithium borate windows, 74 Lithium fluoride disks, 44 Lymphocytoma cutis, radiotherapy

for, 159 Lymphoma, malignant, electron beam

therapy for, 140, 141

Machlett x-ray machine, 162, 163 Malignancies, See also Basal cell

carcinoma; Cancer; Carcinoma; Lentigo maligna; Squamous cell carcinoma.

multiple, laser surgery for, 253-54 Maximar x-ray machine, 82 Maximum permissible dose (MPD),

48 for benign skin disease, 51 lead protection and, 41

Meclofenamic acid for dermatitis suppression, 50

Megavoltage therapy, 72, 85-90

Melanoma classification of, 124 laser surgery for, 254 lentigo maligna and, 123 radiotherapy for, 171

Mental illness, radiotherapy and, 60 Mercury arc lamp, 231, 232, 237, 238-

39 Metastases

from breast carcinoma, 144 from radiation-induced cancers, 58 from squamous cell carcinoma, 114

Microirradiation, laser, 248-49 Microscopy, laser, 248-49, 255 Microthermocouple needles, 271, 274 Miescher technique, 122, 123 Milliammeter, 192, 199 Milliamperage, 65 Mitosis, radiation and, 27, 31 Mohs' chemosurgery, 220 Mucositis, radiotherapy and, 106, 110 Mycosis fungoides

age and sex distribution of, 151 electron beam therapy for, 140-43 percentage depth dose for, 148 phototherapy for, 242 radiotherapy for, 115-17 teleroentgen therapy for, 147-52 ultrasoft x rays for, 169

National Council on Radiation Protection, dose-limiting recommendations of, 61

Needles, microthermocouple, 271, 274 Neodymium laser, 246 Neodymium-Y AG laser, 246 Nerve block anesthesia, 218 Neutron irradiation, 24-25 Nevus

electrosurgery for, 219 flammeus, grenz-ray therapy for,

168 galvanic surgery for, 196 of Jadassohn, 225-26

Nitrogen, liquid, for cryosurgery, 270-74

Nitrous oxide for cryosurgery, 271 Nominal single dose (NSD), 22 Nose

basal cell carcinoma of, 101-3,275-76,277

lentigo malign a of, 127, 132 shielding of, radiation, 101-3

Nummular eczema, grenz-ray therapy for, 182-83

Occupation, radiation exposure and, 53-55, 61

Ohm's law, 187, 190 Orthovoltage therapy, 72 Oscillating circuits, 204, 205, 207 Oxygen

enhancement ratio (OER), 23

Index 287

hyperbaric, 25 radiation and, 23, 24-25

Pacemakers, electrosurgery and, 209-10

Pagers disease, electrosurgery for, 224

Pair production, photon, 86 Papillomas, electrosurgery for, 216,

219 Parapsoriasis, radiotherapy for, 158 Paronychia, radiotherapy for, 158 Pemphigus, ultrasoft x rays for, 167 Penis, Bowen's disease of, 130, 134 Period, electromagnetic, 1 Perma Tweez, 197 Personnel, radiation protection of, 47 Philips x-ray machines, 74, 81, 83

calibration of, 120 Photoelectric absorption, 85 Photoelectric effect, 5 Photography, Kirlian

chemoluminescent, 255 Photons, I. SCI' also Radiation.

absorption of, 4-5 atten uation data for, 6-7 energies of, 1-2 molecular interactions of. 17 production of, 2-3

pair, 86 quality of, 5-7

Phototherapy, 228-44 for acne vulgaris, 241 for alopecia, 241-42 blacklight, 230, 231, 233-34 carbon arc, 229, 231, 232 clinical uses, 230-35, 241-43 exposure time determination, 234 eye protection and, 237 fluorescent sunlamp, 230.231,239-

40 glasses for, 237, 238 high intensity, 239 for jaundice, neonatal, 242 lasers and, 249 for mycosis fungoides, 242 for pitYliasis rosea, 241 for psoriasis, 242-43 quartz, 231, 234, 237-39 sources of light for, 228-30 wavelengths for, 229, 233 xenon arc, 231, 239

Picker x-ray machine, 118 Piezoelectric crystals, 265 Pigmentation

grenz-ray therapy and, 174 lentigo maligna and, 123, 125 nevoid, 219. See a/so Nevus.

roentgen erythema, 50 ultrasoft x-ray therapy and, 165

Pityriasis rosea. phototherapy for, 241

Planck's constant, 1

288 Index

Plantar warts, 218 cryosurgery for, 272, 273 shielding for radiotherapy of, 46 ultrasound for, 268

Plaques atopic dermatitis, 183 conjunctivalleukoplakic,97, 113 lichenified dermatitis, 166

Plasma torch, 250, 257-60 Poikiloderma atrophicans vasculare,

ultrasoft x rays for, 167 Polarity, galvanic surgery and, 192 Polarization, electrosurgery and, 207 Polystyrene, 140 Port-wine stains

electrosurgery for, 216 grenz-ray therapy for, 168 laser surgery for, 252-53

Potentiometer, 192, 195, 199 Precancerous lesions

electrosurgery for, 224-25 ultrasoft x rays for, 169

Protection laser surgery, 247-48 radiotherapy. See Shielding,

radiation. Pruritus, radiotherapy for

lichenification in, 159 Pseudorecidives, 113 Pseudosarcoma, 58 Psoralens, 239, 243 Psoriasis

coal tar for, 242 Goeckerman regimen for, 242-43 phototherapy for, 242-43 radiotherapy for, 158

electron beam, 144 grenz-ray, 166-67, 180-82

PUV A therapy, 243 Pyodermas, radiotherapy for, 158 Pyrimidines, radiotherapy and, 34-35

Quanta, 1 Quartz

cold, 231, 234, 238-39 hot, 231, 234, 237-38 ultrasound and, 265

Quartz-iodine lamp, 231 Queyrat, erythroplasia of, 130, 134, 224

R, international, 164 Radiation. See also Radiotherapy.

absorption, 4-5, 85-86 adverse sequelae of, 49-62, 108-10,

113 ultrasoft rays and, 164-66, 176-

77 annual whole body, 61 attenuation of, 6-7, 13 backscatter factor, 9-11 braking (bremsstrahlung), 2-4, 5, 7 calibration of. See X-ray machines,

calibration of.

carcinoma induced by, 56,113-14 cataracts from, 61, 97 cell survival and, 18-24 chromosomal damage by, 30-31, 61 crusting after, II 0 damage, site of, 18 dermatitis caused by. See

Radiodermatitis. divergence, 12 DNA effects from, 18, 31-32 dosimetry, 7-9

absorbed dose, 8-9, 67-68 air dose, 67 for carcinoma, 109, 114, 119, 120 definitions, 67-68 depth dose, 9-14,67-68,70,89 erythema dose, 49, 157 exit dose, 68 exposure dose, 7 grenz-ray therapy, 157, 162, 174 half-dose depth (H-DD), 68, 118 lethal dose, 18 limits recommended, 61, 62 lowest effective dose, 46-47 MPD. See Maximum permissible

dose. multiple doses, cell survival and,

21-22 mycosis fungoides, 116, 148 nominal single dose (NSD), 22 percentage depth dose, 11-13,

148 skin dose, 10, 67 surface dose, 67 teleroentgen, 149-50, 153 tolerance and, 155-56

effects of, on other tissues than skin, 156-57

environmental, 61 erythema from, 49, 50-51, 108-10,

156, 157 exposure, 7-8 fall-off ratio, 14 filtration, 66-67, 161, 162 fractionation, 21-22, 24 global, 230, 232 half-value layer (HVL), 6-7. See

also Half-value layer. HeLa cells and, 18, 32 homogeneity factor, 7 intensity of, 3 interactions of, with matter, 17,85-

86 itching and, 110 leakage, 39, 41, 48 lifetime total dosage of, 47 linear energy transfer (LET) and,

17-18, 23-24, 25 loss, 3, 5 mucositis and, 106, 110 neutron, 24-25 noncutaneous effects of, 59-61 occupational, 53-55

oxygen and, 23, 24-25 primary effects of cutaneous, 49-50 protection, 39-48. See also

Shielding, radiation. of geographic vicinity, 39-42 of office personnel, 47 of patient, 42-47

quality of, 5-7, 66-67, 156, 157, 161 quantity, 67 repair of injury from, 20-21 RNA and, 27 scattered, 13, 39, 40, 41-42, 47-48 skin sparing, megavoltage and, 88 tolerance of skin to, 155-56 TSD. See Target-skin distance. ulcers caused by, 56,110, 113 ultrasoft. See Grenz-ray therapy;

Ultrasoft x rays. ultraviolet, 229, 236, 237-40 useful (direct), 39, 40-41, 47 water and, 18 whole body teleroentgen, 147-48 x-ray phenomena and, 1-7

Radiobiologic equivalent (REE), 18, 48,62

Radiobiology, 17-25 Radiodermatitis, 49, 51-55

acute, 51-53 chronic, 53-55, 149 clinical aspects, 51-55 histology, 52, 55 malignancy from, 114 occupational, 53-55 teleroentgen therapy and, 149 treatment of, 52

Radiotherapy. See also Radiation. of acne, 60, 159, 170 advantages of, 95-96 alopecia and, 96, 113, 164-65 of benign dermatoses, 155-59 of Bowen's disease, 114-15, 129-

37, 169, 178 calibration. See X-ray machines,

calibration of. of carcinoma, 95-115,119,120,169

recurrent, 170-71 schedules for, 109

of cavernous hemangioma, 167-68 cell kinetics and, 27-35 cones, 39, 42 contact, 72, 74-75, 76-78, 81 chemotherapy and, 33-35 cosmetic results, 96, 113 current usage of, 91-94 delayed regression after, 113 of dermatitis, 158, 166 disadvantages of, 96-97 dosage. See Radiation dosimetry. of ear, 103-6 for eczema, 158 electron beam. See Electron beam

therapy. of eye, 97-101

grenz, 72, 73-74. See also Grenz-ray therapy.

for hemangiomas, 159, 167-68 for herpes simplex, 167 for hidradenitis suppurativa, 158,

171 for hirsutism, 159 for Hodgkin's disease, 117 for hyperhidrosis, 155. 159 indications for, 91, 93-94 for infectious skin disorders, 158-

59 intermediate, 72 of keloids, 159, 168-69 of keratoacanthoma, 114, 119 of keratosis follicularis, 167 of leishmaniasis, 170 of lentigo ma1igna, 122-29, 169 for lichenification in pruritus, 159 for lichen planus, 158, 167 of lip, 106-8 of lymphocytoma cutis, 159 of malignancies, 95-120 megavoltage, 72, 85-90 of melanomas, 171 of mycosis fungoides, 115-17, 169 of nevus flammeus, 168 of nose, 101-3 orthovoltage, 72 for parapsoriasis, 158 for paronychia, 158 for pemphigus, 167 physical aspects of, 1-15, 65-71 planning, 65-83, 90 of poikiloderma atrophicans

vasculare, 167 of precancerous tumors, 169 of psoriasis, 158, 166-67 of pyoderma, 158 recurrence rates and, 110-13 results of, 110-14 schedules, 109, 119 for seborrheic dermatitis, 167 shielding. See Radiation protection;

Shielding, radiation. soft, 72, 75, 76, 79, 146, 149, 152 Strandquist curve for time-dose

relationship of, 21-22 superficial. See Superficial x-ray

therapy. supervoltage, 72 of swimming pool granuloma, 169-

70 techniques, 71-83, 97 teleroentgen. See Teleroentgen

therapy. training for, 92 tube, principal parts of, 3 ultrasoft or supersoft. See Grenz-

ray therapy~ Ultrasoft x rays.

Rads, 17 conversion factor for, from

roentgens, 9, 11

Raynaud's phenomenon, ultrasound for, 267

Razor-blade scalpel, electrosurgery and, 215, 219

RBE. See Relative biologic effectiveness.

Rectifiers, 188, 190 Refrigerants for cryosurgery, 271 Relative biologic effectiveness (RBE),

18,62 maximum permissible dose and, 48

Rem, 62 Reproductive failure, radiation and,

30-31 Resonator circuits, 204, 205 RetroaUlicular area, lentigo maligna

of, 125, 127 Rheostat, 192, 195 Rhinophyma, electrosurgery for, 225 RN A, radiation and, 27 Roentgen

conversion factor for, to rads, 9, 11 energy equivalence of, 9 definition of, 8, 48

Roentgen erythema, 50-51 Roentgen ulcer, 56 Ruby laser, 246, 251

Salivary gland tumors, radiation­caused, 60

Sandbags, radiotherapy and, 44, 45 Sarcoma, Kaposi's. See Kaposi's

sarcoma. Saucerization, electrosurgical, 210,

213 Scalpel

laser, 250 plasma, 250, 257-60 razor-blade, 215, 219

Scars cryosurgery and, 275 electrocautery and, 201-2 electrosurgery and, 208, 214, 217,

225 epilation and, 199 keloid. See Keloids. plasma torch and, 260

Scatter, radiation, 13,39,40,41-42, 47-48

Schedules, radiotherapy, 109, 119 Scrotum, angiokeratoma of, x-ray

therapy and, 177 Seborrheic keratoses, electrosurgery

for, 219-20 Shielding, radiation, 39-48, 97-108,

157 ear, 103-6 eye, 97-101 gonads, 44, 60-61 Gougelman, 98, 99, 101 for grenz rays, 174, 175 "hockey stick," 1 07, 108 lip, 106-8

Index 289

nose, 101-3 for teleroentgen therapy, 147, 150 for ultrasoft x rays, 165

Siemens Dermopan x-ray unit, 80 calibration of, 119

Sine wave current, 207-8 SI units, 8 Skin dose, 10, 67 Skin sparing, megavoltage and, 88 Soft x-ray therapy, 72, 75

machines for, 76, 79 teleroentgen, 146, 149, 152

Solenoid, 204 Source-skin distance (SSD), 65-66 Spark gap generator, 204, 206, 212 Spark gap machines for epilation, 197-

98 Spectroscopy, microemission, 248 S phase of cell division, 27, 29, 31-32 Spider angiomas

electrosurgery for, 216 laser surgery for, 253

Squamous cell carcinoma, 114, 144 electrosurgery for, 223 radiotherapy of, 114, 119

grenz-ray, 178 schedules for, 109, 119 ultrasoft, 165, 169

as radiotherapy complication, 56, 113-14

of supramanubrial area, 182 Strandquist curve, 21-22 Sunlamps, 230, 231, 239-40

fluorescent, 230, 231 Sunlight, therapeutic value of, 228,

236-37 Superficial x-ray therapy, 72, 73, 157

for acne, 170 indications for, 91, 93 machines for, 76, 78

Supervoltage therapy, 72 Swimming pool granuloma, ultras oft x

rays for, 169-70 Synchrony, cell, 27-29, 33-34

Target-skin distance (TSD), 9-10. 65-66

for grenz rays, 174 percentage depth dose and, 12, 13

Tattoos, laser surgery for, 251-52 TEA CO2 laser, 246 Teleroentgen therapy. 146-53

for benign dermatoses, 152-53 dosage, 149-50. 153 half- or quarter-body irradiation, 149 historical background, 146-47 indications for, 150-51 for mycosis fungoides, 116, 117,

147-52 protection, 147, 150 results of, 151-52 side etlects of, 151 total body irradiation. 147-48

290 Index

Telangiectasia electrosurgery for, 216 grenz-ray therapy and, 176 from radiotherapy, 51, 53

Temple, lentigo maligna of, 126, 128 Thermal gradients, cryosurgical, 272 Thermionic tubes, 188, 190 Thumb, Bowen's disease of, 129,

133 Thyroid cancer, radiation-induced,

59-60 Tinea capitis, adverse effects of

radiotherapy for, 54, 59, 60 Tissue reactions

to lasers, 247 to radiation, 156-57 to ultrasound, 266

Toe, carcinoma of, x-ray therapy for, 175, 176

Toe nails, shielding for radiotherapy of,45

Tolerance, radiation, 155-56 Total body irradiation, teleroentgen,

147-48 Training for radiotherapy, 92 Transformers, isolation, 192 Trihydroxyethylrutoside for

erythema, 50 Trunk, basal cell epitheliomas of, 178-

80 Tube housing, radiation, 39, 48 Tumors. See also specific types, e.g.,

Basal cell carcinoma; Epitheliomas.

benign, electrosurgery for, 216 oxygen deficiency and, 24

Tunable dye lasers, 246

Ulcers laser surgery for, 255 radiation-caused, 56, 110, 113 ultrasound for, 267

Ultrasoft x rays, 161-70. See also Grenz-ray therapy.

adverse effects of, 164-66, 176-77

backscatter and, 164 calibration for, 162, 164 half-value depth for, 164 for herpes simplex, 167, 183-84

indications for, 166-70 physical and technical

considerations, 161-64 Ultrasound, 262-69

absorption coefficient, 263, 266 application techniques, 267 as diathermy, 262-63, 266 generator, 265-66 physics and biophysics, 262-65 physiologic effects, 266-67 for ulcers, 267 uses of, dermatologic, 267-68 for warts, 268

Ultraviolet laser systems, 246 Ultraviolet light, 229, 236

artificial sources of, 237-40 erythema threshold and, 240-41 vitamin D and, 240

Universal x-ray machine, 174 Urologic electrosurgery, 209-10

Vacuum tube, 188, 190 oscillator, 205-6

Vagina, Bowen's disease of, 135, 136 Valve tube

epilators, 198 generator, 205-6, 212 rectifiers, 188, 190

Van de Graaff generator, 139 Vascular tumors

electrosurgery for, 216 laser surgery for, 252-53

Venereal warts, 218 Verrucae (warts)

cryosurgery for, 272, 273 electrosurgery for, 216-18 shielding for radiotherapy of

(plantar), 46 ultrasound for, 268

Viruses, warts and, 216-17 Vitamin D, ultraviolet radiation and,

240 Voltage, 187-88

for electrosurgery, 203 Voltmeters, 162 Vulva, Bowen's disease of, 131, 135,

136-37

Warts. See Verrucae. Water, radiation and, 18

Wave forms, diathermy, 204, 205 Wavelengths, 1-2

equivalent, 7 phototherapy, 229, 233 ultrasound, 263

Wens, electrosurgery for, 225

Xenon arc light, 231, 239 global radiation and, 233

X-ray machines, 75-83 beryllium-window, 74, 80, 147-49.

See also Beryllium-window machines.

betatron, 87 Bucky, 82 calibration of, 42, 47, 69-70, 119-

20 Dermopan, 119 grenz-ray, 162, 164, 174

Chaoul,74 cobalt-60, 86 contact, 74-78, 81 Dermopan, 80, 118, 119 General Electric Maximar, 82 glass-window, for teleroentgen

therapy, 149 grenz-ray, 73-74, 76, 77, 162-64,

174 housing for, 39, 48 linear accelerator, 86-87, 139-40 Machlett, 162, 163 megavo1tage, 86-87 milliamperage, 65 Philips, 74,81,83, 120 Picker, 118 placement of, 40, 41 soft, 76, 79 superficial, 76, 78, 157 voltmeters, 162

X rays, 1-7. See also Radiation; Radiotherapy; and specific types, e.g., Grenz-ray therapy; Ultrasoft x rays.

electron interactions with, 4-5 position of, in electromagnetic

spectrum, 1, 2 production of, 2-4

Zygomatic area, lentigo maligna of, 126