• Title/Summary/Keyword: Dose of Fetus

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Fetal dose from Head and Neck Tomotherapy Versus 3D Conformal Radiotherapy

  • Park, So Hyun;Choi, Won Hoon;Choi, Jinhyun
    • Journal of Radiation Protection and Research
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    • v.44 no.4
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    • pp.156-160
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    • 2019
  • Background: To compare the dose of radiation received by the fetus in a pregnant patient irradiated for head and neck cancer using helical tomotherapy and three-dimensional conformal radiation therapy (3DCRT). Materials and Methods: The patient was modeled with a humanoid phantom to mimic a gestation of 26 weeks. Radiotherapy with a total dose of 2 Gy was delivered with both tomotherapy (2.5 and 5.0 cm jaw size) and 3DCRT. The position of the fetus was predicted to be 45 cm from the field edge at the time of treatment. The delivered dose was measured according to the distance from the field edge and the fetus. Results and Discussion: The accumulated dose to the fetus was 1.6 cGy by 3DCRT and 2 and 2.3 cGy by the 2.5 and 5 cm jaw tomotherapy plans. For tomotherapy, the fetal dose with the 2.5 cm jaw was lower than that with the 5 cm jaw, although the radiation leakage was greater for 2.5 cm jaw plan due to the 1.5 fold longer beam-on time. At the uterine fundus, tomotherapy with a 5 cm jaw delivered the highest dose of 2.4 cGy. When the fetus moves up to 35 cm at the 29th week of gestation, the resultant fetal doses for 3DCRT and tomotherapy with 2.5 and 5 cm jaws were estimated as 2.1, 2.7, and 3.9 cGy, respectively. Conclusion: For tomotherapy, scattering radiation was more important due to the high monitor unit values. Therefore, selecting a smaller jaw size for tomotherapy may reduce the fetal dose. however, evaluation of risk should be individually performed for each patient.

Evaluation of the Fetal Dose during Prophylactic Placement of Internal Iliac Artery Balloon Occlusion Catheters in Placenta Accreta (유착태반환자의 예방적 내장골동맥 풍선카테터 설치술 시행 시 태아선량 평가)

  • Kim, Dong-Sik;Ahn, Sung-Min
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.313-321
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    • 2016
  • Placenta accrete patients whose mother mortality rates are rather high due to massive bleeding during childbirth need to have Prophylactic placement of Internal Iliac Artery Balloon Occlusion Catheters procedure to reduce amount of blood loss and inoperative transfusion. Nevertheless, studies for mothers inevitably exposed to dose during PIIABOCs procedure have not been published many yet. Therefore, this study is to investigate exact information on radiation dose exposed to fetus during PIIABOCs procedure. Average effective dose of fetus per organ is 2.38~8.83 mGy, measured highest at beam center and followed by eyeball, stomach and bladder. The result showed that the longer fluoroscopy time is used, the closer beam center is and the thicker abdominal thickness is, the more effective dose on fetus is increasing. When using the collimator and protection shown to decrease the effective dose and when using higher the patient table shown to decrease the effective dose. It has been reported that the threshold of deterministic effect is about 100mGy. Deterministic effect was regarded as a factor that would influence on fetus exposed by medical radiation than stochastic effect. Consequently, it concluded that dose exposed on fetus in PIIABOCs procedure was approximately 10% of threshold of deterministic effect with effective dose of 0.49~18.27 mGy.

Placenta Transfer and Toxicokinetics of Valproic Acid in Pregnant Cynomolgus Monkeys

  • Jeong, Eun-Ju;Yu, Wook-Joon;Kim, Choong-Yong;Chung, Moon-Koo
    • Toxicological Research
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    • v.26 no.4
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    • pp.275-283
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    • 2010
  • Placenta transfer study in non-human primate (NHP) is one of the crucial components in the assessment of developmental toxicity because of the similarity between NHP and humans. To establish the method to determine placenta transfer in non-human primate, toxicokinetics of valproic acid (VPA), a drug used to treat epilepsy in pregnant women, were determined in pregnant cynomolgus monkeys. After mating, pregnancy-proven females were daily administered with VPA at dose levels of 0, 20, 60 and 180 mg/kg by oral route during the organogenesis period from gestation day (GD) 20 to 50. Concentrations of VPA and its metabolite, 4-ene-VPA, in maternal plasma on GDs 20 and 50, and concentrations of VPA and 4-ene-VPA in placenta, amniotic fluid and fetus on GD 50 were analyzed using LC/MS/MS. Following single oral administration of VPA to pregnant monkeys, concentrations of VPA and 4-ene-VPA were generally quantifiable in the plasma from all treatment groups up to 4-24 hours post-dose, demonstrating that VPA was absorbed and the monkeys were systemically exposed to VPA and 4-ene-VPA. After repeated administration of VPA to the monkeys, VPA was detected in amniotic fluid, placenta and fetus from all treatment groups, demonstrating that VPA was transferred via placenta and the fetus was exposed to VPA, and the exposures were increased with increasing dose. Concentrations of 4-ene-VPA in amniotic fluid and fetus were below the limit of quantification, but small amount of 4-ene-VPA was detected in placenta. In conclusion, pregnant monkeys were exposed to VPA and 4-ene-VPA after oral administration of VPA at dose levels of 20, 60 and 180 mg/kg during the organogenesis period. VPA was transferred via placenta and the fetus was exposed to VPA with dose-dependent exposure. The metabolite, 4-ene VPA, was not detected in both amniotic fluid and fetus, but small amount of 4-ene-VPA was detected in placenta. These results demonstrated that proper procedures to investigate placenta transfer in NHP, such as mating and diagnosis of pregnancy via examining gestational sac with ultrasonography, collection of amniotic fluid, placenta and fetus after Caesarean section followed by adequate bioanalysis and toxicokinetic analysis, were established in this study using cynomolugus monkeys.

Shielding for Critical Organs and Radiation Exposure Dose Distribution in Patients with High Energy Radiotherapy (고 에너지 방사선치료에서 환자의 피폭선량 분포와 생식선의 차폐)

  • Chu, Sung-Sil;Suh, Chang-Ok;Kim, Gwi-Eon
    • Journal of Radiation Protection and Research
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    • v.27 no.1
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    • pp.1-10
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    • 2002
  • High energy photon beams from medical linear accelerators produce large scattered radiation by various components of the treatment head, collimator and walls or objects in the treatment room including the patient. These scattered radiation do not provide therapeutic dose and are considered a hazard from the radiation safety perspective. Scattered dose of therapeutic high energy radiation beams are contributed significant unwanted dose to the patient. ICRP take the position that a dose of 500mGy may cause abortion at any stage of pregnancy and that radiation detriment to the fetus includes risk of mental retardation with a possible threshold in the dose response relationship around 100 mGy for the gestational period. The ICRP principle of as low as reasonably achievable (ALARA) was recommended for protection of occupation upon the linear no-threshold dose response hypothesis for cancer induction. We suggest this ALARA principle be applied to the fetus and testicle in therapeutic treatment. Radiation dose outside a photon treatment filed is mostly due to scattered photons. This scattered dose is a function of the distance from the beam edge, treatment geometry, primary photon energy, and depth in the patient. The need for effective shielding of the fetus and testicle is reinforced when young patients ate treated with external beam radiation therapy and then shielding designed to reduce the scattered photon dose to normal organs have to considered. Irradiation was performed in phantom using high energy photon beams produced by a Varian 2100C/D medical linear accelerator (Varian Oncology Systems, Palo Alto, CA) located at the Yonsei Cancer Center. The composite phantom used was comprised of a commercially available anthropomorphic Rando phantom (Phantom Laboratory Inc., Salem, YN) and a rectangular solid polystyrene phantom of dimensions $30cm{\times}30cm{\times}20cm$. the anthropomorphic Rando phantom represents an average man made from tissue equivalent materials that is transected into transverse 36 slices of 2.5cm thickness. Photon dose was measured using a Capintec PR-06C ionization chamber with Capintec 192 electrometer (Capintec Inc., Ramsey, NJ), TLD( VICTOREEN 5000. LiF) and film dosimetry V-Omat, Kodak). In case of fetus, the dosimeter was placed at a depth of loom in this phantom at 100cm source to axis distance and located centrally 15cm from the inferior edge of the $30cm{\times}30cm^2$ x-ray beam irradiating the Rando phantom chest wall. A acryl bridge of size $40cm{\times}40cm^2$ and a clear space of about 20 cm was fabricated and placed on top of the rectangular polystyrene phantom representing the abdomen of the patient. The leaf pot for testicle shielding was made as various shape, sizes, thickness and supporting stand. The scattered photon with and without shielding were measured at the representative position of the fetus and testicle. Measurement of radiation scattered dose outside fields and critical organs, like fetus position and testicle region, from chest or pelvic irradiation by large fie]d of high energy radiation beam was performed using an ionization chamber and film dosimetry. The scattered doses outside field were measured 5 - 10% of maximum doses in fields and exponentially decrease from field margins. The scattered photon dose received the fetus and testicle from thorax field irradiation was measured about 1 mGy/Gy of photon treatment dose. Shielding construction to reduce this scattered dose was investigated using lead sheet and blocks. Lead pot shield for testicle reduced the scatter dose under 10 mGy when photon beam of 60 Gy was irradiated in abdomen region. The scattered photon dose is reduced when the lead shield was used while the no significant reduction of scattered photon dose was observed and 2-3 mm lead sheets refuted the skin dose under 80% and almost electron contamination. The results indicate that it was possible to improve shielding to reduce scattered photon for fetus and testicle when a young patients were treated with a high energy photon beam.

The Evaluation of Radiation Dose to Embryo/Fetus and the Design of Shielding in the Treatment of Brain Tumors (임산부의 전뇌 방사선 치료에 있어서의 태아의 방사선량 측정 및 차폐 구조의 설계)

  • Cho, Woong;Huh, Soon-Nyung;Chie, Eui-Kyu;Ha, Sung-Whan;Park, Yang-Gyun;Park, Jong-Min;Park, Suk-Won
    • Journal of Radiation Protection and Research
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    • v.31 no.4
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    • pp.203-210
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    • 2006
  • Purpose : To estimate the dose to the embryo/fetus of a pregnant patient with brain tumors, and to design an shielding device to keep the embryo/fetus dose under acceptable levels Materials and Methods : A shielding wall with the dimension of 1.55 m height, 0.9 m width, and 30 m thickness is fabricated with 4 trolleys under the wall. It is placed between a Patient and the treatment head of a linear accelerator to attenuate the leakage radiation effectively from the treatment head, and is placed 1 cm below the lower margin of the treatment field in order to minimize the dose to a patient from the treatment head. An anti-patient scattering neck supporters with 2 cm thick Cerrobend metal is designed to minimize the scattered radiation from the treatment fields, and it is divided into 2 section. They are installed around the patient neck by attach from right and left sides. A shielding bridge for anti-room scattered radiation is utilized to place 2 sheets of 3 mm lead plates above the abdomen to setup three detectors under the lead sheets. Humanoid phantom is irradiated with the same treatment parameters, and with and without shielding devices using TLD, and ionization chambers with and without a build-up cap. Results : The dose to the embryo/fetus without shielding was 3.20, 3.21, 1.44, 0.90 cGy at off-field distances of 30, 40, 50, and 60 cm. With shielding, the dose to embryo/fetus was reduced to 0.88, 0.60, 0.35, 0.25 cGy, and the ratio of the shielding effect varied from 70% to 80%. TLD results were 1.8, 1.2, 0.8, 1.2, and 0.8 cGy. The dose measured by the survey meter was 10.9 mR/h at the patient's surface of abdomen. The dose to the embryo/fetus was estimated to be about 1 cGy during the entire treatment. Conclusion : According to the AAPM Report No 50 regarding the dose limit of the embryo/fetus during the pregnancy, the dose to the embryo/fetus with little risk is less than 5 cGy. Our measurements satisfy the recommended values. Our shielding technique was proven to be acceptable.

Placental Transfer and Pharmacokinetics of a Single Oral Dose of the Fluoroquinolone Antibacterial DW-116 in Rats (랫드에서 fluoroquinolone 항균제 DW-116의 단회 경구투여에 의한 태반통과와 약물동태연구)

  • 김종춘;신호철;허정두;이종화;정문구;윤효인
    • Biomolecules & Therapeutics
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    • v.10 no.1
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    • pp.43-49
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    • 2002
  • The present study was conducted to investigate the placental transfer and pharmacokinetics of the flu-oroquinolone antibacterial DW-116 in pregnant rats. The placental transfer and pharmacokinetics of DW-116 were examined after a single oral dose of 500 mg $^{14}C$ DW-116/kg on gestational day 18. Maternal and fetal tissues were collected at 0.17 0.5,1,2,4,8, and 24 h after dosing. Maximum radioactivity was detected in maternal plasma, placenta, and whole fetus at 1 h, and in amniotic plasma at 4 h after dosing. Thereafter, radioactivity gradually disappeared from these tissues and was 16~28% of maximum levels at 24 h after dosing. Radioactivity in whole fetus were higher than those in the maternal plasma and placenta. The $T_{1/2,abs}$, $T_{1/2,{\beta}},$ AUC, $T_{max},$ and $C_{max}$ in the maternal plasma were approximately 6 min, 13.3 h, 1620 $ug^*hr/ml,$ 0.5 h, and 136 ug/ml, respectively. Those in the placenta were approximately 20 min, 12.3 h, 2150 $ug^*h/$m\ell$,$ 1.0 h, and 172 ug/ml, respectively. Those in the whole fetus were 13 min, 12.8 h,2549 $ug^*h/$m\ell$,$ 1 h, and 191 ug/ml, respectively. In the amniotic fluid of maternal uterus, the 4T_1/2,abs}$, $T1/2,{\beta},$ AUC, $T_{max},$ and $C_{max}$ were approximately 1.3 h,9.3 h,2508 $ug^*h/$m\ell$,$ 4.4 h, and 135 ug/ml, respectively. While DW-116 disappeared biphasically from maternal plasma, whole fetus and placenta, it was eliminated monophasically from amniotic fluid. In conclusion, this study demonstrated that the absorption and distribution of DW-116 in maternal plasma and placenta were extensively rapid, and that the test chemical well passed the blood-placenta barrier and was transferred to the fetus.

Comparison of the Mercury Levels Between Maternal and Fetal Organs in Pregnant Fisher-344 Rats (염화메틸수은에 폭로된 임신 흰쥐에서 모체와 태자의 장기에 축적된 수은농도의 비교)

  • 이진헌
    • Journal of Environmental Health Sciences
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    • v.20 no.3
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    • pp.39-48
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    • 1994
  • The purpose of this study was to determine the mercury accumulated at maternal and fetal organs, and compare its levels between maternal and fetal organs on day 20 of gestation, in pregnant Fisher-344 rats which given orally methylmercuric chloride on day 7 of gestation. Pregnant rats were divided four groups by dose: control group, and methylmercuric chloride treatment groups of 10, 20 and 30 mg/kg, respectively. The results obtained are as follows: I The mercury concentrations in maternal organs were the highest in kidney, and followed by blood, spleen, liver and brain. 2. The slopes of regression equation among mercury dose levels in maternal organs were as follows: Kidney 3.62 (r$^2$=0.943), Blood 2.75 (r$^2$=0.941), Spleen 2.49 (r$^2$=0.990), Liver 1.13 (r$^2$= 0.949), Brain 0.33 (r$^2$=0.984). 3. The mercury concentrations in fetal organs and placenta were the highest in liver, and followed by kidney, placenta and brain. 4. The slopes of regression equation among mercury dose levels in fetal organs and placenta were as follows: Liver 1.79 (r$^2$= 0.968), Kidney 0.79 (r$^2$= 0.976), Placenta 0.68 (r$^2$= 0.920), Brain 0.52 (r$^2$= 0.978), All Body 0.58 (r$^2$= 0.941). 5. As to the mercury levels in kidney, dams were 4.8~14.9 times higher than fetus. But as to the mercury levels in liver and brain, fetus were 1.6~2.5 and 1.5~1.9 times higher than dams. In conclusion, the mercury which exposured to pregnant rats can easily pass through the placenta and accumulated in fetus, especially higher in fetal liver and brain.

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Sibjeondaebotang and Yugmijihwangtang's Toxicological Effects on Rat's Fetus (십전대보탕과 육미지황탕이 실험동물의 태자에 미치는 독성학적 연구)

  • Han, Sang-Baek;Jeon, Seong-Jin;Shin, Heon-Tae;Park, Hae-Mo;Lee, Sun-Dong;Park, Chul-Soo
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.3
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    • pp.35-45
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    • 2008
  • Purpose : To evaluate safety of Sibjeondaebotang and Yugmijihwangtang in rats' fetus Methods : Female Sprague-Dawley rats were orally administered with the Sibjeondaebotang and Yugmijihwangtang at dose of 5mg/kg/day for 20 days. Pregnant rats were sacrificed at 20th day of gestation. Approximately live fetuses in the 20th day of gestation were randomly selected and fixed in 95% ethanol. To observe skeletal malformations, fetuses were stained with alcian blue and alizarin red S. Results : Neonatal body weight and number of fetus of Sibjeondaebotang, Yugmijihwangtang group were increased to those of control group. The fetuses treated with Sibjeondaebotang, Yugmijihwangtang didn't showed external malformation. Vertebral and sternal skeletal variations were observed in Sibjeondaebotang, Yugmijihwangtang administered group, but compared to the control, those skeletal variations were insignificant. There were no significant changes in number of ribs, cervical, thoracic, lumbar, sacral and caudal vertebrae Conclusion : From these results, it can be concluded that Sibjeondaebotang, Yugmijihwangtang shows no toxicity effects on fetus body weight and number of live fetuses. Although skeletal variations were shown in vertebrate and sternum, Sibjeondaebotang, Yugmijihwangtang did not show significant changes in bone malformation.

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