• Title/Summary/Keyword: Radiation Emergency Medicine

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Conclusions and Suggestions on Low-Dose and Low-Dose Rate Radiation Risk Estimation Methodology

  • Sakai, Kazuo;Yamada, Yutaka;Yoshida, Kazuo;Yoshinaga, Shinji;Sato, Kaoru;Ogata, Hiromitsu;Iwasaki, Toshiyasu;Kudo, Shin'ichi;Asada, Yasuki;Kawaguchi, Isao;Haeno, Hiroshi;Sasaki, Michiya
    • Journal of Radiation Protection and Research
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    • v.46 no.1
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    • pp.14-23
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    • 2021
  • Background: For radiological protection and control, the International Commission on Radiological Protection (ICRP) provides the nominal risk coefficients related to radiation exposure, which can be extrapolated using the excess relative risk and excess absolute risk obtained from the Life Span Study of atomic bomb survivors in Hiroshima and Nagasaki with the dose and dose-rate effectiveness factor (DDREF). Materials and Methods: Since it is impossible to directly estimate the radiation risk at doses less than approximately 100 mSv only from epidemiological knowledge and data, support from radiation biology is absolutely imperative, and thus, several national and international bodies have advocated the importance of bridging knowledge between biology and epidemiology. Because of the accident at the Tokyo Electric Power Company (TEPCO)'s Fukushima Daiichi Nuclear Power Station in 2011, the exposure of the public to radiation has become a major concern and it was considered that the estimation of radiation risk should be more realistic to cope with the prevailing radiation exposure situation. Results and Discussion: To discuss the issues from wide aspects related to radiological protection, and to realize bridging knowledge between biology and epidemiology, we have established a research group to develop low-dose and low-dose-rate radiation risk estimation methodology, with the permission of the Japan Health Physics Society. Conclusion: The aim of the research group was to clarify the current situation and issues related to the risk estimation of low-dose and low-dose-rate radiation exposure from the viewpoints of different research fields, such as epidemiology, biology, modeling, and dosimetry, to identify a future strategy and roadmap to elucidate a more realistic estimation of risk against low-dose and low-dose-rate radiation exposure.

Gastrointestinal Emergency in Neonates and Infants: A Pictorial Essay

  • Gayoung Choi;Bo-Kyung Je;Yu Jin Kim
    • Korean Journal of Radiology
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    • v.23 no.1
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    • pp.124-138
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    • 2022
  • Gastrointestinal (GI) emergencies in neonates and infants encompass from the beginning to the end of the GI tract. Both congenital and acquired conditions can cause various GI emergencies in neonates and infants. Given the overlapping or nonspecific clinical findings of many different neonatal and infantile GI emergencies and the unique characteristics of this age group, appropriate imaging is key to accurate and timely diagnosis while avoiding unnecessary radiation hazard and medical costs. In this paper, we discuss the radiological findings of essential neonatal and infantile GI emergencies, including esophageal atresia and tracheoesophageal fistula, hypertrophic pyloric stenosis, duodenal atresia, malrotation, midgut volvulus for upper GI emergencies, and jejunoileal atresia, meconium ileus, meconium plug syndrome, meconium peritonitis, Hirschsprung disease, anorectal malformation, necrotizing enterocolitis, and intussusception for lower GI emergencies.

Evaluation of Tungsten Blended Filament Shields Made by 3D Printer in Radiography (일반촬영분야에서의 3D 프린터로 제작한 텅스텐 혼합 필라멘트 차폐체의 성능평가)

  • Yoon, Joon;Yoon, Myenog-Seong
    • Journal of radiological science and technology
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    • v.44 no.6
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    • pp.615-621
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    • 2021
  • In the medical field, radiation provides information for the diagnosis and treatment of diseases. As the use of radiation increases and the risk of exposure increases, interest in radiation protection is also rapidly increasing. Lead shielding material is mainly used, which has a risk of lead poisoning and absorption into the body. Tungsten mixed filament shielding sheets were fabricated with a size of 70 × 70 mm and a thickness of 1, 2, and 4 mm by using a 3D printer. In the general shooting experiment, the thickness of the shielding sheet is 1 ~ 5mm, the tube voltage is 60, 80, 100, 120 kVp and the tube current is 20, 40 mAs. In general photography, Tungsten showed better shielding rate compared to Brass, Copper, and Lead protective tools under all irradiation conditions, and in particular, Tungsten 5 mm showed 100% shielding rate. The 3D-printed tungsten mixed filament shielding is expected to be used as a new shield that can replace the existing lead protection tools as it shows a better shielding rate than the existing lead protection tools in Radiography.

Experience with Gabapentin for Neuropathic Pain -Case report- (신경병증성 통증 환자에서 Gabapentin 사용의 임상경험 -증례 보고-)

  • Lim, Kyung-Joon;Chung, Yong-Hun;Cho, Nam-Su
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.242-245
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    • 1999
  • Gabapentin is an oral antiepileptic agent with an unknown mechanism of action. There have been many proposed uses for gabapentin, including neuropathic pain, reflex sympathetic dystrophy, postherpetic neuralgia, midscapular pain secondary to radiation myelopathy and migraine prophylaxis. This report presents patients who were treated with gabapentin when other pharmacologic interventions failed to relieve neuropathic pain 3 patients with neuropathic pain were included among these cases. All patients were started on 200 mg gabapentin. The maximum dose required for pain relief was between 800 mg and 2400 mg. Gabapentin may be a useful adjunct for treating neuropathic pain with minimum of side effects.

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From Radon and Thoron Measurements, Inhalation Dose Assessment to National Regulation and Radon Action Plan in Cameroon

  • Saidou;Shinji Tokonami;Masahiro Hosoda;Augustin Simo;Joseph Victor Hell;Olga German;Esmel Gislere Oscar Meless
    • Journal of Radiation Protection and Research
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    • v.47 no.4
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    • pp.237-245
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    • 2022
  • Background: The current study reports measurements of activity concentrations of radon (220Rn) and thoron (220Rn) in dwellings, followed by inhalation dose assessment of the public, and then by the development of regulation and the national radon action plan (NRAP) in Cameroon. Materials and Methods: Radon, thoron, and thoron progeny measurements were carried out from 2014 to 2017 using radon-thoron discriminative detectors (commercially RADUET) in 450 dwellings and thoron progeny monitors in 350 dwellings. From 2019 to 2020, radon track detectors (commercially RADTRAK) were deployed in 1,400 dwellings. It was found that activity concentrations of radon range in 1,850 houses from 10 to 2,620 Bq/㎥ with a geometric mean of 76 Bq/㎥. Results and Discussion: Activity concentrations of thoron range from 20 to 700 Bq/㎥ with a geometric mean of 107 Bq/㎥. Thoron equilibrium factor ranges from 0.01 to 0.6, with an arithmetic mean of 0.09 that is higher than the default value of 0.02 given by UNSCEAR. On average, 49%, 9%, and 2% of all surveyed houses have radon concentrations above 100, 200, and 300 Bq/㎥, respectively. The average contribution of thoron to the inhalation dose due to radon and thoron exposure is about 40%. Thus, thoron cannot be neglected in dose assessment to avoid biased results in radio-epidemiological studies. Only radon was considered in the drafted regulation and in the NRAP adopted in October 2020. Reference levels of 300 Bq/㎥ and 1,000 Bq/㎥ were recommended for dwellings and workplaces. Conclusion: Priority actions for the coming years include the following: radon risk mapping, promotion of a protection policy against radon in buildings, integration of the radon prevention and mitigation into the training of construction specialists, mitigation of dwellings and workplaces with high radon levels, increased public awareness of the health risks associated with radon, and development of programs on the scientific and technical aspects.

A study on Protector Performance Evaluation According to X-ray Scattering Distribution of Portable Radiation System (이동형 방사선 발생장치 차폐물 설치에 관한 연구)

  • Kim, Hyong-Gyun;Sung, Dong-Keon;Cho, Kyong-Mi;Kim, Sang-Beom;Kim, Jae-Young;Choi, Jun-Ho
    • Korean Journal of Digital Imaging in Medicine
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    • v.11 no.2
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    • pp.85-92
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    • 2009
  • This study, "The study about performance evaluations of mobile cover for X-ray's diffusion and distribution in mobile radiation" is based on the rules of mobile defense apparatus for radiation producer in 2006. To use the mobile cover for X-ray for diagnosis has been compulsory in common wards except operation rooms, emergency rooms and intensive care units. we have confirmed the effect in arbitrary shielding material after Qualitiy Control was carried out for accuracy in an experiment of mobile photographing equipment. The performance evaluation was conducted with the fabrics of selenium, 0.2 mmPb, 0.1 mmPb and aluminiums. Considering the result, we choosed 0.1 mmPb and attached cover to mobile photographing equipment. We have finished making the cover after drew up the draft to attach cover to mobile photographing equipment through the modeling and the structural analysis. the process of the study is that we assembled the manufactured structures and carried out the practical experiment to take the photograph after attaching the fabric of 0.1 mmPb to mobile photographing equipment. It is need of additional thesises hereafter that we compare the result between the part to improve for safety besides convenience in photographic experiment about clinical radiation and the effect of covering the diffusion in condition attached the cover.

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Using 2-mSv Appendiceal CT in Usual Practice for Adolescents and Young Adults: Willingness Survey of 579 Radiologists, Emergency Physicians, and Surgeons from 20 Hospitals

  • Hyuk Jung Kim;Kyoung Ho Lee;Min-Jeong Kim;Sung Bin Park;Yousun Ko;LOCAT Group
    • Korean Journal of Radiology
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    • v.21 no.1
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    • pp.68-76
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    • 2020
  • Objective: To survey care providers' willingness to use 2-mSv computed tomography (CT) in their usual practice for adolescents and young adults with suspected appendicitis. Materials and Methods: An ethical committee approved this prospective study. We introduced 2-mSv CT in 20 hospitals through a pragmatic clinical trial. At the final phase of the trial, we invited 698 potentially-involved care providers in the survey regarding their willingness to use 2-mSv CT. Multivariable logistic regression analyses were performed to identify factors associated with willingness. Nine months after the completion of the trial patient recruitment, we surveyed whether the hospitals were using 2-mSv CT in usual practice. Results: The analyses included responses from 579 participants (203 attendings and 376 trainees; 221 radiologists, 196 emergency physicians, and 162 surgeons). Regarding the willingness to immediately change their standard practice to 2-mSv CT, 158 (27.3%), 375 (64.8%), and 46 (7.9%) participants responded as "yes" (consistently), "partly" (selectively), and "no", respectively. Willingness varied considerably across the hospitals, but only slightly across the participants' departments or job titles. Willingness was significantly associated with attendings (p = 0.004), intention to maintain the dedicated appendiceal CT protocol (p < 0.001), belief in compelling evidence on the carcinogenic risk of conventional-dose CT radiation (p = 0.028), and hospitals having more than 1000 beds (p = 0.031). Fourteen of the 20 hospitals kept using 2-mSv appendiceal CT in usual practice after the trial. Conclusion: Despite the extensive efforts over the years of this clinical trial, many care providers were willing to use 2-mSv CT selectively or not willing to use.

Cranial Irradiation in the Management of Childhood Leukemic Hyperleukocytosis (극심한 백혈구 증가증을 보이는 소아 백혈병 환자에서 전두개 방사선치료)

  • Hong, Se-Mie;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.142-145
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    • 2001
  • Purpose : Acute leukemia with hyperleukocytosis (more than $10^5/mm^3$) is at high risk of early sudden death, usually from intracerebral hemorrhage. Emergency cranial irradiation is a relatively simple approach to solve this the problem. We summarized our experience of cranial irradiation in 24 leukemic children who presented with hyperleukocytosis. Methods and Materials : Between 1990 and 1998, 40 children with acute leukemia presenting with hyperleukocytosis were referred for emergency cranial irradiation. Among these patients, 24 children were evaluable. There were 16 boys and eight girls, their ages ranged from 2 to 13 years (median 9.5 years). The initial leukocyte counts ranged $109,910/mm^3\;to\;501,000/mm^3$. Peripheral blood smear was peformed in all patients and noted the morphology of the blast. Introduction of emergency cranial irradiation was determined by the leukocyte counts (more than 100,000/mm) and the existence of the blast in peripheral blood smear. All patients were treated with intravenous hydration with alkaline fluid and oral allopurinol. Cranial irradiation started on the day of diagnosis. With 2 Gy in one fraction in 4 patients, 4 Gy in two fractions in 20 patients. Results : The WBC count had fallen in 19 patients (83%) and no intracerebral hemorrhage occurred after irradiation. There were five cases of early deaths. Four patients died of metabolic complications, and one patient with intracerebral hemorrhage. He died 5 hours after cranial irradiation. No patient had any immediate side effect from cranial irradiation. Conclusion : Our data suggest, that emergency cranial irradiation can be safely chosen and effective in childhood leukemic patients presenting with high leukocyte counts.

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The Japan Health Physics Society Guideline on Dose Monitoring for the Lens of the Eye

  • Yokoyama, Sumi;Tsujimura, Norio;Hashimoto, Makoto;Yoshitomi, Hiroshi;Kato, Masahiro;Kurosawa, Tadahiro;Tatsuzaki, Hideo;Sekiguchi, Hiroshi;Koguchi, Yasuhiro;Ono, Koji;Akiyoshi, Masahumi;Kunugita, Naoki;Natsuhori, Masahiro;Natsume, Yoshinori;Nabatame, Kuniaki;Kawashima, Tsunenori;Takagi, Shunji;Ohno, Kazuko;Iwai, Satoshi
    • Journal of Radiation Protection and Research
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    • v.47 no.1
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    • pp.1-7
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    • 2022
  • Background: In Japan, new regulations that revise the dose limit for the lens of the eye (hereafter the lens), operational quantities, and measurement positions for the lens dose were enforced in April 2021. Based on the international safety standards, national guidelines, the results of the Radiation Safety Research Promotion Fund of the Nuclear Regulation Authority, and other studies, the Working Group of Radiation Protection Standardization Committee, the Japan Health Physics Society (JHPS) developed a guideline for radiation dose monitoring for the lens. Materials and Methods: The Working Group of the JHPS discussed the criteria of non-uniform exposure and the management criteria set not to exceed the dose limit for the lens. Results and Discussion: In July 2020, the JHPS guideline was published. The guideline consists of three parts: main text, explanations, and 26 examples. In the questions, the corresponding answers were prepared, and specific examples were provided to enable similar cases to be addressed. Conclusion: With the development of the guideline on radiation dose monitoring of the lens, radiation managers and workers will be able to smoothly comply with revised regulations and optimize radiation protection.

Feasibility of Reflecting Improvement of Tumor Hypoxia by Mild Hyperthermia in Experimental Mouse Tumors with $^18F-Fluoromisonidazole$ (저온온열치료에 의한 종양 내 저산소상태 개선효과를 $^18F$-Fluoromisonidazole의 섭취 변화를 이용한 평가)

  • Lee Sang-wook;Ryu Jin Sook;Oh Seung Joon;Im Ki Chun;Chen Gi Jeong;Lee So Ryung;Song Do Young;Im Soo Jeong;Moon Eun Sook;Kim Jong Hoon;Ahn Seung Do;Shin Seong Soo;Lee Kyeong Ryong
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.288-297
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    • 2004
  • Puporse: The aims of this study were to evaluate the change of $[^18F]fluoromisonidazole$($[^18F]FMISO$) uptake in C3H mouse squamous cell carcinoma-VII (SCC-VII) treated with mild hyperthermia ($42^{circ}C$) and nicotinamide and to assess the biodistribution of the markers in normal tissues under similar conditions. Methods and Materials: $[^18F]FMISO$ was producedby our hospital. Female C3H mice with a C3H SCC-VII tumor grown on their extremities were used. Tumors were size matched. Non-anaesthetized, tumor-bearing mice underwent control or mild hyperthermia at $42^{circ}C$ for 60 min with nicotinamide (50 mg/kg i.p. injected) and were examined by gamma counter, autoradiography and animal PET scan 3 hours after tracer i.v. injected with breathing room air, The biodistribution of these agents were obtained at 3 h after $[^18F]FMISO$ injection. Blood, tumor, muscle, heart, lung, liver, kidney, brain, bone, spleen, and intestine were removed, counted for radioactivity and weighed. The tumor and liver were frozen and cut with a cryomicrotome into 10- um sections. The spatial distribution of radioactivity from the tissue sections was determined with digital autoradiography. Results: The mild hyperthermia with nicotinamide treatment had only slight effects on the biodistribution of either marker in normal tissues. We observed that the whole tumor radioactivity uptake ratios were higher in the control mice than in the mild hyperthermia with nicotinamide treated mice for $[^18F]FMISO$ ($1.56{\pm}1.03$ vs. $0.67{\pm}0.30$; p=0.063). In addition, autoradiography and animal PET scan demonstrated that the area and intensity of $[^18F]FMISO$ uptake was significantly decreased. Conclusion: Mild hyperthermla and nicotinamide significantly improved tumor hypoxia using $[^18F]FMISO$ and this uptake reflected tumor hypoxic status.