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One of the most widely available technologies to clean the air in homes of particulate matter of less than 2.5 ��m in diameter (PM2.5), known to have negative health impacts, are portable home air purifiers (HAPs). This paper presents research which (1) explored the effectiveness of HAPs in real-world conditions in 57 homes in three European cities; (2) examined if HAPs affect users��� perceptions of the indoor air quality (IAQ) at home; and (3) considered the motivations for occupants��� operation of HAPs. Results from this study found that PM2.5 concentrations in bedrooms were reduced by 45% to 69%; perceptions of IAQ were not correlated with measured high PM2.5 levels; occupants reported the HAPs to have a ���cooling��� effect, which may explain why the predominant driver of HAP use was thermal comfort, rather than IAQ, in all three cities. The latter finding was supported by a statistically significant increase in the probability of HAP use with increasing indoor temperatures. If the operation of HAPs can be managed, or fully automated, to reflect indoor air pollution levels rather than thermal conditions, better pollutant reduction would be feasible and their use to reduce PM2.5 may help mitigate the negative health effects of exposure whilst at home.

Aims Previous studies have shown that ultraviolet light can lead to the release of nitric oxide from the skin and decrease blood pressure. In contrast to visible light the local application of ultraviolet light bears a cancerogenic risk. Here, we investigated whether whole body exposure to visible blue light can also decrease blood pressure and increase endothelial function in healthy subjects. Methods In a randomised crossover study, 14 healthy male subjects were exposed on 2 days to monochromatic blue light or blue light with a filter foil (control light) over 30 minutes. We measured blood pressure (primary endpoint), heart rate, forearm vascular resistance, forearm blood flow, endothelial function (flow-mediated dilation), pulse wave velocity and plasma nitric oxide species, nitrite and nitroso compounds (secondary endpoints) during and up to 2 hours after exposure. Results Blue light exposure significantly decreased systolic blood pressure and increased heart rate as compared to control. In parallel, blue light significantly increased forearm blood flow, flow-mediated dilation, circulating nitric oxide species and nitroso compounds while it decreased forearm vascular resistance and pulse wave velocity. Conclusion Whole body irradiation with visible blue light at real world doses improves blood pressure, endothelial function and arterial stiffness by nitric oxide released from photolabile intracutanous nitric oxide metabolites into circulating blood.

Background: Visible light is absorbed by photoacceptors in pigmented and non-pigmented mammalian cells, activating signaling cascades and downstream mechanisms that lead to the modulation of cellular processes. Most studies have investigated the molecular mechanisms and therapeutic applications of UV and the red to near infrared regions of the visible spectrum. Considerably less effort has been dedicated to the blue, UV-free part of the spectrum. Objective: In this review, we discuss the current advances in the understanding of the molecular photoacceptors, signaling mechanisms, and corresponding therapeutic opportunities of blue light photoreception in non-visual mammalian cells in the context of inflammatory skin conditions. Methods: The literature was scanned for peer-reviewed articles focusing on the molecular mechanisms, cellular effects, and therapeutic applications of blue light. Results: At a molecular level, blue light is absorbed by flavins, porphyrins, nitrosated proteins, and opsins; inducing the generation of ROS, nitric oxide release, and the activation of G protein coupled signaling. Limited and contrasting results have been reported on the cellular effects of blue light induced signaling. Some investigations describe a regulation of proliferation and differentiation or a modulation of inflammatory parameters; others show growth inhibition and apoptosis. Regardless of the elusive underlying mechanism, clinical studies show that blue light is beneficial in the treatment of inflammatory skin conditions. Conclusion: To strengthen the use of blue light for therapeutic purposes, further in depth studies are clearly needed with regard to its underlying molecular and cellular mechanisms, and their translation into clinical applications.

Clinical investigations prove that blue light irradiation reduces the severity of psoriasis vulgaris. Nevertheless, the mechanisms involved in the management of this condition remain poorly defined. Despite the encouraging results of the clinical studies, no clear guidelines are specified in the literature for the irradiation scheme regime of blue light-based therapy for psoriasis. We investigated the underlying mechanism of blue light irradiation of psoriatic skin, and tested the hypothesis that regulation of proliferation is a key process. We implemented a mechanistic model of cellular epidermal dynamics to analyze whether a temporary decrease of keratinocytes hyper-proliferation can explain the outcome of phototherapy with blue light. Our results suggest that the main effect of blue light on keratinocytes impacts the proliferative cells. They show that the decrease in the keratinocytes proliferative capacity is sufficient to induce a transient decrease in the severity of psoriasis. To study the impact of the therapeutic regime on the efficacy of psoriasis treatment, we performed simulations for different combinations of the treatment parameters, i.e., length of treatment, fluence (also referred to as dose), and intensity. These simulations indicate that high efficacy is achieved by regimes with long duration and high fluence levels, regardless of the chosen intensity. Our modeling approach constitutes a framework for testing diverse hypotheses on the underlying mechanism of blue light-based phototherapy, and for designing effective strategies for the treatment of psoriasis.

Background Psoriasis and atopic dermatitis are two inflammatory skin diseases with a high prevalence and a significant burden on the patients. Underlying molecular mechanisms include chronic inflammation and abnormal proliferation. However, the cell types contributing to these molecular mechanisms are much less understood. Recently, deconvolution methodologies have allowed the digital quantification of cell types in bulk tissue based on mRNA expression data from biopsies. Using these methods to study the cellular composition of the skin enables the rapid enumeration of multiple cell types, providing insight into the numerical changes of cell types associated with chronic inflammatory skin conditions. Here, we use deconvolution to enumerate the cellular composition of the skin and estimate changes related to onset, progress, and treatment of these skin diseases. Methods A novel signature matrix, i.e. DerM22, containing expression data from 22 reference cell types, is used, in combination with the CIBERSORT algorithm, to identify and quantify the cellular subsets within whole skin biopsy samples. We apply the approach to public microarray mRNA expression data from the skin layers and 648 samples from healthy subjects and patients with psoriasis or atopic dermatitis. The methodology is validated by comparison to experimental results from flow cytometry and immunohistochemistry studies, and the deconvolution of independent data from isolated cell types. Results We derived the relative abundance of cell types from healthy, lesional, and non-lesional skin and observed a marked increase in the abundance of keratinocytes and leukocytes in the lesions of both inflammatory dermatological conditions. The relative fraction of these cells varied from healthy to diseased skin and from non-lesional to lesional skin. We show that changes in the relative abundance of skin-related cell types can be used to distinguish between mild and severe cases of psoriasis and atopic dermatitis, and trace the effect of treatment. Conclusions Our analysis demonstrates the value of this new resource in interpreting skin-derived transcriptomics data by enabling the direct quantification of cell types in a skin sample and the characterization of pathological changes in tissue composition. Electronic supplementary material The online version of this article (10.1186/s12920-019-0567-7) contains supplementary material, which is available to authorized users.

In diesem Kapitel geht es um den Einsatz der Phototherapie zur Behandlung dermatologischer Erkrankungen. Neben der Therapievariante mit UV-Licht wird auch auf die Moglichkeit der Therapie mit blauem Licht eingegangen.

Volatile sulfur compounds of an interspecific hybrid between Allium cepa and Allium porrum were analyzed by gas chromatography (GC) and GC/mass spectrometry prior to isolation of the individual oils by a simultaneous distillation/extraxtion (SDE) method. Furthermore, the aroma profiles of various onion and leek cultivars were investigated. Major volatile components detected in onion were 2-methyl-2-pentenal, (E)-methyl 1-propenyl disulfide, methyl propyl trisulfide, and propanethiol, whereas dipropyl trisulfide, dipropyl disulfide, and (E)-propenyl propyl disulfide predominated in leek oils. According to the higher amount of leek chromosomes in the cell nucleus, the percentages of the measured sulfur volatiles in the hybrid material correspond more to the leek than to the onion flavor profile. Discrimination analysis was successfully applied to classify the three predefined Allium groups. It has been found that at minimum five of the most important aroma volatiles were necessary to receive sufficient diff...

Dendritic cells (DC) are potent APC that may be involved in the pathogenesis of HIV-1 infection. We studied the APC function of DC from HIV-1-infected subjects that were derived from monocyte-depleted PBMC by culture in human IL-4 and human granulocyte-macrophage CSF. The cultured cells from the HIV-1-infected subjects had similar morphology and phenotype of mature DC (CD80 = 41 +/- 8%, CD86 = 77 +/- 5%, CD40 = 87 +/- 6%, CD1a = 1 +/- 1%) to DC cultured from seronegative subjects. The yield of these DC was lower than from HIV-1-seronegative subjects (4 +/- 0% vs 11 +/- 2%, p < 0.01), and the lower DC yields correlated with lower numbers of blood CD4+ T cells (r = 0.60, p < 0.01) and higher plasma viral load (r = -0.49, p < 0.01). DC from HIV-1-infected subjects were infected with recombinant vaccinia virus vectors expressing Gag, Pol, and Env and were able to stimulate equal or higher levels of MHC class I-restricted, anti-HIV-1 memory CTL (CTLm) than were similarly treated, autologous B lymphocyte cell lines. DC pulsed with peptides representing HIV-1 CTL epitopes stimulated higher levels of anti-HIV-1 CTLm responses than did DC infected with the vaccinia virus-HIV-1 constructs. Allogeneic, MHC class I-matched DC also stimulated anti-HIV-1 CTLm activity in cells from HIV-1-infected subjects. DC from early and late stages of HIV-1 infection had a similar ability to activate CTLm specific for targets expressing either HIV-1 genes via vaccinia virus vectors or HIV-1 immunodominant synthetic peptides. However, DC from either early or late stages of HIV-1 infection could not overcome the defect in anti-HIV-1 CTLm response in advanced infection.

Loss of anti-human immunodeficiency virus type 1 (HIV-1) memory cytotoxic T-lymphocyte (CTLm) responses is associated with disease progression in HIV-1 infection. In this study, nonspecific stimulation of peripheral blood mononuclear cells (PBMC) from HIV-1-infected homosexual men with anti-CD3 monoclonal antibody (MAb) was compared with antigen-specific stimulation with inactivated, autologous B lymphoblastoid cells (B-LCL) infected with a vaccinia virus vector encoding HIV-1 IIIb Gag, Pol, and Env (VV-GPE) for activation of HIV-1-specific CTLm responses in a bulk lysis assay and by precursor frequency analysis. The results show that VV-GPE-infected B-LCL stimulated on average 10-fold greater anti-HIV-1 CTLm activity, as detected in the bulk lysis assay, and 55-fold-greater CTLm precursor frequencies specific for the three HIV-1 structural proteins than did stimulation with anti-CD3 MAb. This effect was noted with both freshly donated and frozen-thawed PBMC. The lysis was mediated by CD8+ T cells and was restricted by the major histocompatibility class I complex. These data indicate that antigen-specific stimulation with VV-GPE-infected B-LCL is a highly efficient method for detection of anti-HIV-1 CTLm responses that is applicable to noncurrent prospective studies with frozen PBMC.

The dissociative recombination of vibrationally cold CD[sup +] with electrons in the energy range of 0.01 eV to 60 eV has been measured using the Test Storage Ring in a merged beam arrangement. New resonance structures are observed with prominent peaks at 0.8 eV, 8.6 eV, and 11.7 eV. While the second and third resonance are readily attributed to direct recombination processes through Rydberg levels with dissociating molecular ion cores, the origin of the first resonance structure is not well understood, however, its small width of 0.45 eV is an indication of an indirect recombination process.

A high current injector for the heavy ion storage ring TSR in Heidelberg is under construction. As a part of the injector eight seven-gap resonators with high shunt impedance are being developed. These resonators ( ƒ 0 = 108.48 MHz ) are designed for the synchronous velocities of β s = 3.7, 4.5, 5.1 and 5.7%. Low power models with scaling factors of 1:2.5 were built in order to study the characteristics of these new resonators. Following low level measurements to optimize the voltage distribution and eigenfrequency, a first power resonator was built and successfully tested at 80 kW (duty cycle of 25%). At this power, the resonator generated a maximum voltage (summation of all gap amplitude voltages) of 1.75 MV. This paper describes the design of the resonators and gives some details of the measurements.

A newly designed radio frequency cavity was used at the storage ring TSR in Heidelberg to accelerate stored /sup 12/C/sup 6+/ (E/sub 0/=73.3 MeV) beams. It was possible to accelerate about 90% of the stored particles by more than a factor of three in kinetic energy (E/sub fin/ /spl ap/240 MeV). A new operating mode of the machine close to the transition energy was also investigated. Up to 10 /spl mu/A /sup 12/C/sup 6+/ and protons could be stored, however the beams were susceptive to longitudinal instabilities. For 21 MeV protons (/spl gamma/=1.02) a /spl gammasub tr/ parameter of 1.04 could be reached. A new method to produce a beam of polarized ions, based on spin selective attenuation by a polarized atomic hydrogen target was successfully proved with 23 MeV protons. To minimize losses of the beam particles the TSR was operated in the low-beta mode. After one hour a beam polarisation of 0.014 was achieved. >

The polarization of τ leptons produced in the reaction e+e−→τ+τ− at the Z resonance has been measured using the τ decay modes eνeντ, μνμντ, πντ, ϱντ, and a1ντ. The mean value obtained is Pτ = −0.152±0.045, indicating that parity is violated in the neutral current process e+e− → τ+τ−. The result corresponds to a ratio of a neutral current vector and axial vector coupling constants of the τ lepton g V τ (M 2 Z ) g A τ (M 2 Z ) = 0.076±0.023 and a value of the electroweak mixing parameter sin2θw(M2Z) = 0.2302 ± 0.0058.

Background: In a collaborative study, patients with untreated normal-tension glaucoma were randomly assigned to a marked intraocular pressure reduction group or to a no therapy group. It was anticipated that medical therapy and laser trabeculoplasty would generally not achieve adequate pressure lowering and that fistulizing surgery would be required. This hypothesis was examined using current observations in the study. Methods: Patients randomized to the therapy group had a pressure reduction of at least 30% from their last prerandomization level. This was achieved within 6 months by means of fistulizing surgery or with pilocarpine and/or laser trabeculoplasty. Betablockers and adrenergic agonists were excluded from both eyes. Results: Of 30 patients with documented stable 30% pressure reduction, 17 (57%) achieved this with topical medication and/or laser trabeculoplasty: 8 with pilocarpine alone, 2 with laser trabeculoplasty alone, and 7 with laser trabeculoplasty after initial topical medication. The remaining 13 (43%) patients required a single fistulizing procedure. There was no statistically significant difference between the mean follow-up time for the nonfistulized group (533.8 ± 437.6 days) and for the fistulized group (502.7 ± 344.7 days). Both treatment groups had similar baseline profiles. Conclusion: Marked pressure reduction can be achieved and maintained on a longterm basis by means other than fistulizing surgery in a large proportion of patients with untreated normal-tension glaucoma.

This study aimed to evaluate the ability and role of ultrasound biomicroscopy in imaging the peripheral retina, pars plana, and anterior choroid.The study design was a case series.Seventeen eyes of 17 patients with a variety of clinical diagnoses involving the anterior portion of the posterior segment were studied.High-frequency (50 MHz), high-resolution (50 microns) ultrasound biomicroscopy was performed.Ultrasound biomicroscopy was capable of imaging the peripheral retina, pars plana, and anterior choroid. Images had features consistent with known histopathology. Retinoschisis consisted of one thin hyper-reflective echo and could be differentiated from a retinal detachment, which was thicker and formed a bilayered echo. A choroidal effusion could be identified as an echolucent space within the suprachoroidea, whereas a choroidal hemorrhage was moderately echodense. Inflammatory diseases, such as a sarcoid granuloma, pars planitis, and Harada's disease, were characterized by different forms of uveal thickening. A ciliochoroidal nevus was internally hyporeflective and could be measured accurately and localized.Imaging of the peripheral retina, pars plana, and anterior choroid is possible with ultrasound biomicroscopy and may aid in the diagnosis and management of pathology involving this region.

Both radiation and anthracycline antibiotics may produce reactive oxygen species to cause cytotoxicity, and it has been suggested that some cellular antioxidant enzymes may be important for resistance to these agents. The human breast adenocarcinoma cell line MCF-7WT has a low level of glutathione peroxidase (GPX) activity. We have transfected MCF-7WT cells with a plasmid that contains the cDNA for human GPX under the transcriptional control of the human metallothionein IIA promoter. One transfected clone, MCF-GPX-6, contained multiple copies of GPX cDNA/cell and, after exposure to heavy metals, expressed a level of GPX enzyme activity that was 40-fold higher than that present in MCF-7WT cells and comparable to the GPX activity contained in the doxorubicin-resistant MCF-7DOX cell line. No differences in levels of glutathione, catalase, superoxide dismutase, glutathione S-transferase, or glutathione reductase were noted in MCF-GPX-6 cells compared to MCF-7WT cells. MCF-GPX-6 cells were relatively resistant to hydrogen peroxide and tert-butylhydroperoxide compared to MCF-7WT cells, e.g., exposure of both cell lines to 750 microM H2O2 for 1 h resulted in a relative surviving fraction of 0.07 for MCF-7WT and 0.35 for MCF-GPX-6 cells. However, no difference in sensitivity to either radiation or doxorubicin was noted between MCF-7WT and MCF-GPX-6 cells. These results suggest that GPX is not important for the development of cellular resistance to either radiation or doxorubicin.

Lack of disease in long-term nonprogressors with human immunodeficiency virus type 1 (HIV-1) infection was strongly associated with very low copy numbers of HIV-1 DNA and RNA in peripheral blood mononuclear cells and plasma and the presence of high levels of anti-HIV-1 CD8+ memory cytotoxic T lymphocytes specific for Gag, Pol, and Env, compared with levels present in intermediate and advanced progressors. CD8+ memory cytotoxic T lymphocytes may have an important role in controlling HIV-1 replication and preventing disease in long-term nonprogressors.

To evaluate intraobserver and interobserver reproducibility of measurement of images obtained during ultrasound biomicroscopy.Four anterior segment images of four normal patients were obtained by a single examiner. The measurements of three independent observers were compared to assess interobserver reproducibility in quantifying the images. Thirteen different anterior segment parameters were measured by each observer on each image. Intraobserver and interobserver reproducibility of measurement were assessed by calculating the coefficient of variation for each individual observer and by using the F test to detect a difference among observers.Intraobserver reproducibility was high. Interobserver reproducibility for the measured parameters varied considerably and was affected by subjective interpretation of visualized anatomic landmarks.The optimal parameters for quantitative ultrasound biomicroscopy require refinement. Measurements of alterable parameters are best measured presently by a single observer. Ultrasound biomicroscopy has the potential to elucidate anatomic relationships underlying much anterior segment disease, but caution in interpreting quantitative differences is warranted.

1. In the course of 34 days the detectable methanol concentration in freshly squeezed grapefruit and organ juices as well as in grapefruit and orange juice mixes increased to a maximum level of approximately 600 mg/kg. This increase could already be detected at the beginning of the examination i.e. as early as 1 or 2 days after squeezing the fruit juices. At the beginning of the experiments the methanol concentrations were between 10 and 270 mg/kg. 2. After the consumption of pectin (40 g on one day and 2 x 40 g on two days) blood or serum-methanol values respectively were observed which were clearly above the level of chronic alcohol abuse (10 mg/kg). After the ingestion of ethanol (0.5 g/kg bodyweight) the serum-methanol concentration increased even further.

Treatment of human breast (MCF-7) and lung (A549) adenocarcinoma cell lines with 10 micrograms/ml cycloheximide provided substantial protection from paclitaxel-induced cytotoxicity. Addition of cycloheximide to cells at 0, 6, 12 or 18 h into a 24 h exposure to paclitaxel resulted in cytotoxicity similar to that found in cells treated with paclitaxel alone for only 0, 6, 12 or 18 h, respectively. DNA flow cytometry showed that paclitaxel blocked cells in G2/M. Mitotic index studies demonstrated that paclitaxel arrested cells in mitosis and that prolonged exposure to paclitaxel resulted in the development of multiple micronuclei. Concurrent incubation of cells in cycloheximide prevented the development of a G2/M block, mitotic arrest and micronuclei formation. The addition of cycloheximide to cells at 6 or 12 h into a 24 h exposure to paclitaxel reduced the degree of G2/M block to that produced by incubation of cells in paclitaxel alone for only 6 or 12 h. Mitotic index studies confirmed that cells treated with cycloheximide during paclitaxel exposure had a marked reduction in the percentage of cells in mitosis. However, the percentage of paclitaxel-treated cells which had multiple micronuclei was increased in cells treated with cycloheximide. These results indicate that entry into mitosis is a prerequisite for paclitaxel-induced cytotoxicity and that cycloheximide reduces cytotoxicity due to paclitaxel by preventing cells from entering mitosis. However, once cells have entered mitosis in the presence of paclitaxel, protein synthesis is not required for the development of multiple micronuclei and cytotoxicity.

Cytokines that stimulate growth and differentiation of hematopoietic precursor cells have been used as protectors in vivo against ionizing radiation. Recently, we have shown that the nitroxide tempol is also an effective radiation protector in vivo. The purpose of the present study was to determine if the combination of tempol with stem cell factor (SCF, c-kit ligand) would provide enhanced radiation protection in C57 mice compared with the protection afforded by either agent alone. Mice were exposed to whole-body irradiation and assessed for survival at 30 days after irradiation. No control mice survived doses of more than 9 Gy. Treatment of mice before and after radiation with SCF alone (100 micrograms/kg at -20 h, -4 h and +4 h) protected mice from radiation at doses of as high as 10 Gy (76% survival). Tempol (350 mg/kg) given 10 min prior to radiation was a radioprotector at 9 Gy (55% survival). The combination of SCF and tempol increased the survival of mice exposed to radiation doses up to 11 Gy (32% survival for the combination vs 4% for SCF alone and 0% for tempol alone; P0.001 for the combination vs either agent alone). Lower doses of SCF alone (1 microgram/kg) or tempol alone (275 mg/kg) did not protect mice from radiation. However, the combination of these reduced doses of SCF and tempol protected mice from lethal irradiation at 10 Gy. Stem cell factor and tempol given either singly or together were well tolerated by the animals. These data show that SCF and tempol are radiation protectors and that their radioprotective effects are more than additive when the agents are given together.

A choroidal effusion, hypotony, and a shallow anterior chamber developed in a patient following a transconjunctival needling revision of an encapsulated filtering bleb. While choroidal effusions occur frequently following filtration surgery, to our knowledge, this complication has not been previously reported following a filtering bleb needle revision.

We describe a technique of internal suture ligation of the tube of the Molteno seton to prevent hypotony in the immediate postoperative period, without risking infection or inflammation.

A survey was conducted to evaluate nursing home referrals to consultant dietitians of residents with nutrition-related concerns, the frequency of such referrals, and the timeliness of dietitians' responses. The results showed that, although residents with significant weight loss and pressure ulcers constituted a higher proportion of nutrition concerns referred to the dietitian, most referrals were made from a week to a month after the nutrition concern was identified. Residents with tube feedings or dysphagia concerns were more likely to be referred in a more timely manner, within 1 to 2 days.

7602 Background: Numerous reports have demonstrated that the clinical use of thalidomide (THAL) carries a risk for deep venous thrombosis. Only limited investigations into the causative mechanisms for this complication have been conducted. Thrombin generation is a global measurement of hyper or hypocoagulability that has not been used to examine the hypercoagulable state caused by THAL. The aim of this study was to determine if THAL affects thrombin generation in patients with multiple myeloma (MM). Methods: MM patients on and off THAL were recruited. Patients were considered to be “on THAL” if they had been taking the medication for at least three months and “off THAL” if they had not been taking the medication for at least three months. Coagulation tubes of blood containing 3.2% sodium citrate were drawn from each patient. Platelet poor plasma was prepared from these specimens using standard technique. The samples were snap frozen at -70 C and stored until analysis. Thrombin generation was measured using the Calibrated Automated Thrombogram as described by Hemker(Pathophysiol Haemo Thromb 2003;33:4–15) using a microplate fluorometer, the Fluoroskan Ascent from Thermo Electron and the Thrombinoscope software package. The endogenous thrombin potential or ETP (area under the thrombin generation curve) and peak thrombin generation (the maximum release of thrombin per unit of time) were the variables of interest for this study. Results: Twenty seven patients were recruited. Five were excluded from analysis because they were on warfarin or enoxaparin. The normal ETP in females is 1803 ± 241 nM*min and in males is 1745 ± 259 nM *min. Normal peak thrombin generation in females is 318.5 ± 52.9 nM and in males is 293.4 ± 48.5 nM. The t-test was used to compare subjects to normal values.Peak thrombin generation was significantly increased in the 9 subjects taking THAL, 374 ± 10.6 nM (p [Table: see text]

6623 Introduction: R-CHOP is considered standard treatment (tx) for IHGNHL. Administering full doses of R-CHOP is crucial to maximize response. Older patients (pts) may experience a higher incidenc...

A 60-year-old woman was treated postoperatively for carcinoma of the gall bladder with a split course of radiotherapy. The tumour dose (TD) was 61.2 Gy in 34 fractions delivered by an anterior and two lateral wedge fields with 60 Co; the D max was 70% of TD for the anterior field and 150% of the TD at the thin edge of the wedges. She also underwent 5-FU and leucovorin chemotherapy. No skin reaction was seen during radiotherapy or in 1 year of follow-up. A year after radiotherapy she was treated for hypercholesterolaemia by simvastatin. Within 2–3 days a severe skin and subcutaneous reaction developed in the lateral radiation fields but not in the anterior field. To our knowledge, recall of skin radiation reaction after simvastatin therapy has not been previously reported.