• Advances in pediatric surgery
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• v.8 no.1
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• pp.16-22
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• 2002

Between March 1999 and January 2000, 82 boys with the diagnosis of inguinal hernias (12 bilateral and 70 unilateral hernias), underwent Ultrasound (US) examination of both sides of the groin, a total of 164 inguinal imaging prior to surgery. The patients ages ranged from 3 days to 12 years with a mean of 32.6 months. Ninty four examinations were on the clinically symptomatic side and 70 were on the asymptomatic side. The US criteria for the diagnosis of an inguinal hernia were as follows: 1) visceral hernia, the presence of bowel loops, or omentum in the inguinal canal, 2) communicating hydrocele, the presence of fluid in the processus vaginalis, 3) widening of patent processus vaginalis at the level of internal inguinal ring. The width of patent processus vaginalis at the level of internal inguinal ring over 4 mm is considered an occult hernia. Among the 94 symptomatic groins, US findings showed 31 (33%) visceral hernias, 18 (19%) communicating hydroceles, and 38 (41%) widening of the internal inguinal ring, and 7 (7%) groins without abnormalities. In 70 asymptomatic groins, there were 4 (6%) visceral hernias, 5 (7%) communicating hydroceles, 11 (16%) widening of the internal inguinal ring, and 50 (70%) groins without abnormalities. Among the 70 asymptomatic groins there were US abnormalities in 20 (28%). One hundred and seven groins with positive US findings were surgically explored. Among 107 operated sites, the operative findings were compatible with the US diagnosis in 104, a sensitivity for US of 97.2%. In patients with US findings of widening of internal inguinal ring (>4 mm), there was patent processus vaginalis in 36 out of 38 symptomatic groins and 10 of 11 asymptomatic groins. The sensitivity of US to the operative findings in widening of internal inguinal ring was 93.8%. For visceral hernia and communicating hydrocele, the sensitivity of positive US findings was 100%. Ultrasonography for inguinal hernias appears to be a rapid, reliable, and noninvasive screening diagnostic tool with high positive specificity. Therefore, we recommend the use of US as a routine diagnostic tool in pediatric patients with inguinal hernias and hydroceles.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.6-14
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• 1997

To differentiate biliary atresia from intraheaptic cholestasis, Tc-99m DlSIDA hepatobiliary scintigraphies and percutaneous needle biopsies of 60 consecutive infants were evaluated retrospectively. Twenty three patients had biliary atresia and 37 patients intraheaptic cholestasis(neonatal hepatitis 34, TPN induced jaundice 2 and Dubin-Johnson syndrome 1). All sixty patients underwent Tc-99m DlSIDA hepatobiliary scintigraphy with phenobarbital pretreatment. Of 23 patients with biliary atresia, 22 were correctly interpreted showing 96% sensitivity while of 37 patients with intraheaptic cholestasis, only 12 had intestinal excretion of radionuclide showing 32% specificity. Among the forty needle biopsies, 17 of biliary atresia and 23 of intrahepatic cholestasis, 37 were correctly interpreted as either having biliary atresia or intrahepatic cholestasis. The overall diagnostic accuracy was 93%. Of 3 misdiagnosed cases, the histologic findings of two patients with biliary atresia(aged 43 days and 54 days at the first needle biopsy) were essentially the same as those of neonatal hepatitis. Follow-up biopsies, however, showed findings consistent with biliary atresia. The third one(VLBW premie with history of 8 weeks of TPN) showed mild ductal proliferation and portal fibrosis. This was interpreted as suspicious for biliary atresia. Jaundice resolved gradually. In summary, patients who have intestinal excretion of radionuclide on Tc-99m DlSIDA hepatobiliary scintigraphy, biliary atresia can be ruled out. But the patients who do not have intestinal excretion of radionuclide should have further investigation by needle biopsy. Judicious use of Tc-99m DISIDA hepatobiliary scintigraphy and percutaneous needle biopsy can give a diagnostic accuracy of 95% or more in cases of infantile cholestasis.

• Journal of Radiation Protection and Research
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• v.22 no.4
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• pp.227-235
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• 1997

Cytogenetic studies were performed in peripheral blood lymphocytes from hospital workers occupationally exposed to low doses of radiation (0.30 - 40.07mSv). The workers were divided into three groups according to their job area : 18 diagnostic radiology, 17 therapeutic radiology, and 16 nuclear medicine. The control group consisted of 49 non-radiation workers with no history of exposure to radiation. A higher percentage of cells with aberration(1.275%) was observed in the workers compared to the controls(0.677%) and the difference was statistically significant(p<0.001). The frequency of chromosomal aberration was $0.706{\times}10^{-2}$/cell in the exposed and $0.344{\times}10^{-2}$/cell in the control(p<0.05). Chromosomal exchange frequency was $0.083{\times}10^{-2}$/cell in the control vs $0.245{\times}10^{-2}$/cell in the workers. There was no evidence of significant increase of chromosome aberration related to age or to the duration of employment. The frequency of chromosomal exchange in workers of nuclear medicine was $0.313{\times}10^{-2}$/cell, which was significantly higher than in the control($0.083{\times}10^{-2}$/cell) or other working groups: therapeutic radiology($0.265{\times}10^{-2}$/cell), and diagnostic radiology($0.167{\times}10^{-2}$/cell). No dose-effect relation was found between chromosome aberration and total cumulative doses, recent 5 yr, recent 2 yr cumulative dose. But in case of last 1 yr cumulative dose, dose-dependant increase was observed when controls were considered(p<0.05). The radiation dose which workers have received was much lower than the maximum permissible dose, but there was a significant difference in the frequency of chromosome aberration between occupationally exposed workers and control. So, it is clear that chromosome aberration is a quite sensitive indicator of radiation exposure and it can be detected at very low dose level of occupational exposure.

• Journal of Radiation Protection and Research
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• v.14 no.1
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• pp.24-33
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• 1989

The peripheral dose, defined as the dose outside therapeutic photon fields, was estimated for 6MV X-ray linear accelerator. The measurements were performed using silicon diode detectors controlled by automatic controlled water phantom. The effects of field size, collimator position, presence or absence of wedge filter, and wedge angle were analyzed. The results were as follows 1. The peripheral dose decreases as the distance from field margin increases and it is more than 2.4% of central axis maximum dose even at 15cm distance from field margin. 2. Maximum build-up of peripheral dose is at 2-3 mm from the water surface and drops to a minimum at 1.5cm depth and then the dose increase again. 3. The peripheral dose increases as the field size. increases. At the short distance from field margin, the difference of peripheral dose between 5 $\times\;5cm^2$ and 20 $\times\;20cm^2$ field size reaches more than 2 fold. 4. The peripheral dose is higher along the upper collimator than along the lower collimator. The differences is less than 1%. 5. The presence of wedge filter increases peripheral dose. And the peripheral dose is higher along the blade side of wedge filter than along the ridge side. The difference is about 3% at 5cm distance from the field margin for 15 $\times\;15cm^2$ field size and 60$^{\circ}$ wedge filter. 6. The Peripheral dose of wedge filter increases as the wedge filter angle increases and the increasing ratio is about 2 fold in 60$^{\circ}$wedge filter compared with open field.

• Journal of Radiation Protection and Research
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• v.23 no.3
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• pp.123-138
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• 1998

Characteristics of element responses of Panasonic UD802 personnel dosimeters in the X, ${\beta}$, ${\gamma}$, ${\gamma}/X$, ${\gamma}/{\beta}$ and ${\gamma}$/neutron mixed fields were assessed. A dose-response algorithm has been developed to decide the high probability of a radiation type and energy by using the distribution in all six ratios of the multi-element TLD. To calculate the 4-element response factors and ratios between the elements of the Panasonic TLDs in the X, $\beta$, and $\gamma$ radiation fields, Panasonic’s UD802 TLDs were irradiated with KINS’s reference irradiation facility. In the photon radiation field, this study confirms that element-3 (E3) and element-4 (E4) of the Panasonic TLDs show energy dependent both in low- and intermediate-energy range, while element-1 (E1) and element-2 (E2) show little energy dependency in the entire whole range. The algorithm, which was developed in this study, was applied to the Panasonic personnel dosimetry system with UD716AGL reader and UD802 TLDs. Performance tests of the algorithm developed was conducted according to the standards and criteria recommended in the ANSI N13.11. The sum of biases and standard deviations was less than 0.232. The values of biases and standard deviations are distributed within a triangle of a lateral value of 0.3 in the ordinate and abscissa, With the above algorithm, Panasonic TLDs satisfactorily perform optimum dose assessment even under an abnormal response of the TLD elements to the energy imparted. This algorithm can be applied to a more rigorous dose assessment by distinguishing an unexpected dose from the planned dose for the most practical purposes, and is useful in conducting an effective personnel dose control program.

• Journal of Radiation Protection and Research
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• v.25 no.1
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• pp.31-36
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• 2000

In radiotherapy, it may happen to radiate surrounding normal tissue because of inconsistent field size by changing patient position during treatment. We are going to analyze errors reduced by using immobilization device with Electonic portal imaging device(EPID) in this study. We had treated the twenty-one patients in pelvic region with 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at supine position during treatment. They were separated to two groups, 11 patients without device and 10 patients with immobilization device. We used styrofoam for immobilization device and measured the errors of anterior direction for x, y axis and lateral direction for z, y axis from simulation film to EPID image using matching technique. For no immobilization device group, the mean deviation values of x axis and y axis are 0.19 mm. 0.48 mm, respectively and the standard deviations of systematic deviation are 2.38 mm, 2.19 mm, respectively and of random deviation for x axis and y axis are 1.92 mm. 1.29 mm, respectively. The mean deviation values of z axis and y axis are -3.61 mm. 2.07 mm, respectively and the standard deviations of systematic deviation are 3.20 mm, 2.29 mm, respectively and of random deviation for z axis and y axis are 2.73 mm. 1.62 mm, respectively. For immobilization device group, the mean deviation values of x axis and y axis are 0.71 mm. -1.07 mm, respectively and the standard deviations of systematic deviation are 1.80 mm, 2.26 mm, respectively and of random deviation for x axis and y axis are 1.56 mm. 1.27 mm, respectively. The mean deviation values of z axis and y axis are -1.76 mm. 1.08 mm, respectively and the standard deviations of systematic deviation are 1.87 mm, 2.83 mm, respectively and of random deviation for x axis and y axis are 1.68 mm, 1.65 mm, respectively. Because of reducing random and systematic error using immobilization device, we had obtained good reproducibility of patient setup during treatment so that we recommend the use of immobilization device in pelvic region of radiation treatment.

• Journal of Radiation Protection and Research
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• v.35 no.1
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• pp.34-42
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• 2010

With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within $1.5^{\circ}$. Of all fifty hospitals 30.0% were beyond $3^{\circ}$. The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible.

• Journal of Radiation Protection and Research
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• v.33 no.1
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• pp.13-20
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• 2008

The flow rate measurements in a multi-phase flow pipeline were evaluated quantitatively by means of a clamp-on sealed radioisotope based on a cross correlation signal processing technique. The flow rates were calculated by a determination of the transit time between two sealed gamma sources by using a cross correlation function following FFT filtering, then corrected with vapor fraction in the pipeline which was measured by the ${\gamma}$-ray attenuation method. The pipeline model was manufactured by acrylic resin(ID. 8 cm, L=3.5 m, t=10 mm), and the multi-phase flow patterns were realized by an injection of compressed $N_2$ gas. Two sealed gamma sources of $^{137}Cs$ (E=0.662 MeV, ${\Gamma}$ $factor=0.326\;R{\cdot}h^{-1}{\cdot}m^2{\cdot}Ci^{-1}$) of 20 mCi and 17 mCi, and radiation detectors of $2"{\times}2"$ NaI(Tl) scintillation counter (Eberline, SP-3) were used for this study. Under the given conditions(the distance between two sources: 4D(D; inner diameter), N/S ratio: $0.12{\sim}0.15$, sampling time ${\Delta}t$: 4msec), the measured flow rates showed the maximum. relative error of 1.7 % when compared to the real ones through the vapor content corrections($6.1\;%{\sim}9.2\;%$). From a subsequent experiment, it was proven that the closer the distance between the two sealed sources is, the more precise the measured flow rates are. Provided additional studies related to the selection of radioisotopes their activity, and an optimization of the experimental geometry are carried out, it is anticipated that a radioisotope application for flow rate measurements can be used as an important tool for monitoring multi-phase facilities belonging to petrochemical and refinery industries and contributes economically in the light of maintenance and control of them.

• Journal of Radiation Protection and Research
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• v.33 no.1
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• pp.27-34
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• 2008

A Korean urban contamination model METRO-K (${\underline{M}}odel$ for ${\underline{E}}stimates$ the ${\underline{T}}ransient$ Behavior of ${\underline{R}}adi{\underline{O}}active$ Materials in the ${\underline{K}}orean$ Urban Environment, which is capable of calculating the exposure doses resulting from radioactive contamination in an urban environment, is taking part in a model testing program EMRAS (${\underline{E}}nvironmental$ ${\underline{M}}odelling$ for ${\underline{RA}}diation$ ${\underline{S}}afety$) oragnized by the IAEA (${\underline{I}}nternational$ ${\underline{A}}tomic$ ${\underline{E}}nergy$ ${\underline{A}}gency$). For radioactive contamination scenarios of Pripyat districts and a hypothetical RDD (${\underline{R}}adiological$ ${\underline{D}}ispersal$ ${\underline{D}}evice$), the predicted results using METRO-K were submitted to the EMRAS's Urban Contamination Working Group. In this paper, the predicted results for the contamination scenarios of a Pripyat district were shown in case of both without remediation measures and with ones. Comparing with the predictied results of the models that have taken part in EMRAS program, a feasibility for decision-making support of METRO-K was investigated. As a predicted result of METRO-K, to take immediately remediation measures following a radioactive contamination, if possible, might be one of the best ways to reduce exposure dose. It was found that the discrepancies of predicted results among the models are resulted from 1) modeling approaches and applied parameter values, 2) exposure pathways which are considered in models, 3) assumptions of assessor such as contamination surfaces which might affect to an exposure receptor and their sizes, 4) parameter values which are related with remediation measures applied through literature survey. It was indentified that a Korean urban contamination model METRO-K is a useful tool for dicision-making support through the participation of EMRAS program.

• Journal of Radiation Protection and Research
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• v.39 no.4
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• pp.168-175
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• 2014

This study was designed to assess whether the conventional tangential technique, using a multileaf collimator (MLC), allows a reduced dose to the organs at risk (OAR) in breast radiation therapy. A total of forty right and left 20 for each breast cancer patients that underwent radiation therapy after breast conserving surgery were included in this study. For each patient, the planning target volume (PTV) and OAR (heart, left anterior descending artery (LAD), liver and lung) were defined and dose distribution were produced for conventional tangential beams using 6 MV photons. The treatment plans were made using the following two techniques for all patients. For the first plan (P1), MLC was designed to shield as much of OAR as possible without compromising the coverage of PTV. In the second plan (P2), the treatment plan was created without using MLC. Dose-volume histograms for OARs were calculated for all plans. For left breast cancer, the percentage of maximum dose ($D_{max%}$) and mean dose ($D_{mean%}$) of OARs (heart and LAD) were calculated, and for right breast cancer, the percentage of the mean dose ($D_{mean%}$) of the liver was calculated. The $D_{mean%}$ of the lung was calculated in all patients. The mean values of $D_{max%}$ of the heart ($86.9{\pm}19.5%$ range, 35.1-100.6%) in P1 were significantly lower than in P2 ($98.3{\pm}3.4%$ range, 91.7-105.2%) (p=0.001). The mean values of $D_{max%}$ of LAD ($78.4{\pm}22.5%$ range, 26.5-99.7%) in P1 was significantly lower than in P2 ($93.3{\pm}8.1%$ range, 67.9-102.1%) (p<0.001). In P1, the mean values of $D_{mean%}$ of the liver ($4.8{\pm}2.0%$) were significantly lower than in P2 ($6.2{\pm}2.5%$) (p<0.001). The mean values of $D_{mean%}$ of the lung were significantly lower in P1 ($9.3{\pm}2.3%$) than in P2 ($9.7{\pm}2.4%$) (p<0.001). P1, by using MLC, allows a significantly reduced dose to OAR compared with P2. We can suggest that it is reasonable to routinely use MLC in the conventional tangential technique for breast radiation therapy considering the primary tumor location.