• 제목/요약/키워드: Internal Dose

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베체트병 환자에서 저용량 스테로이드 사용과 관련하여 발생한 중심성장액맥락망막병증 (Central serous chorioretinopathy associated with low dose systemic corticosteroid treatment of Behcet's disease)

  • 차성욱;김경진;권성민;이신애;민병철;김은성;이정욱
    • Journal of Yeungnam Medical Science
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    • 제34권1호
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    • pp.111-114
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    • 2017
  • Central serous chorioretinopathy may induce poor eyesight and serous retinal detachment. However, its exact cause has not been well established thus far. It can be associated with systemic high-dose corticosteroid treatment mainly for young and middle-aged men and may spontaneously regress or recur after withdrawal from corticosteroid. After corticosteroid administration for Behcet's disease, it is necessary to identify any ocular symptoms. Behcet's disease can lead to the development of ocular complications, such as uveitis, hypopyon, retinal vasculitis, optic neuritis, angiogenesis, secondary cataract, and glaucoma. It is possible to diagnose any of these complications via optical coherence tomography and digital indocyanine green angiography. It is easy to neglect an ocular symptom that may appear after a low-dose corticosteroid treatment as an ocular complication in patients with Behcet's disease. Thus, we report on a case concerning high-dose corticosteroid treatment with a literature review.

Long-Term Management of a Refractory Corticosteroid Responsive Tremor Syndrome

  • Kim, Soomin;Kim, Yoonji;Kim, Ji-Hee;Kim, Hyeon-Jin;Lee, Ji-Hye;Geum, Migyeong;Kim, Ha-Jung
    • 한국임상수의학회지
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    • 제38권3호
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    • pp.143-146
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    • 2021
  • A 2-year-old intact female Maltese dog was presented with generalized involuntary tremors and nystagmus without regular direction. The dog was conscious the whole time while it was trembling. Its involuntary tremors were alleviated at rest or during sleep. Magnetic resonance imaging (MRI) revealed asymmetric hydrocephalus and caudal occipital malformation. In cerebrospinal fluid (CSF) analysis, a trace of protein was found and total nucleated cell count (TNCC) was slightly increased. However, infectious pathogens were not found. In complete blood count, there was a mild leukocytosis. After the patient received anticonvulsants (midazolam, phenobarbital, KBr), diuretics (furosemide) with an anti-inflammatory drug (prednisolone, 0.5 mg/kg PO bid), and a proton-pump inhibitor (omeprazole), it showed no improvement. The patient was tentatively diagnosed with corticosteroid responsive tremor syndrome. So the anticonvulsants and diuretics were discontinued and the dose of prednisolone was increased to an immunosuppressive dose (1 mg/kg PO bid). After administering the immunosuppressive dose of prednisolone, the patient did not show nystagmus. Its tremors were much alleviated. However, they did not disappear. Five weeks later, the patient showed gradual improvement but still was trembling when moving around. Nine weeks later, its tremors were similar to before. So diazepam (0.3 mg/kg PO sid) was added to the treatment. After that, its tremors were alleviated more. Prednisolone and diazepam were maintained for about five months, with tapering of the dose of prednisolone (until 0.5 mg/kg PO sid). About 7 months later after the treatment was started, the dog was trembling rarely except when it was excited. Therefore, diazepam was discontinued. This case describes a refractory white dog shaker syndrome successfully managed with long-term administration of a steroid and diazepam.

몬테 카를로 전산모사를 통한 EPID의 외부적 선량 재구성과 내부 선량 계측과의 비교 및 분석 (The Comparative Analysis of External Dose Reconstruction in EPID and Internal Dose Measurement Using Monte Carlo Simulation)

  • 정주영;윤도군;서태석
    • 한국의학물리학회지:의학물리
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    • 제24권4호
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    • pp.253-258
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    • 2013
  • 본 연구의 목적은 electronic portal imaging device (EPID)를 통하여 방사선 치료를 받는 환자로부터 투과해 나오는 선량으로 외부적인 선량 재구성과 몬테카를로 전산모사로부터 도출되는 내부 선량 계측과의 관계를 도출하고 이를 분석하기 위한 연구로 진행되었다. 본 연구는 전산모사 연구로써 두 가지의 경우를 비교 분석하고 이와 비슷한 연구에 대한 기본적인 지표를 제공하고자 시행되었다. 실험에 관한 기하학적 정보와 방사선 소스에 대한 정보를 몬테카를로 전산모사 툴인 Monte Carlo n-particle (MCNPX)에 입력하였고 EPID 이미지 도출을 위하여 MCNPX 내에 tally카드를 이용하여 선량정보를 도출하고 이를 영상화 할 수 있도록 하였다. 또한 내부적인 계측을 위하여 물 팬텀을 소스와 표면의 거리(source to surface distance, SSD)가 100 cm이 되도록 설정하였으며, 그보다 10 cm 아래에 EPID를 위치시켰다. 내부 계측은 물팬텀 자체에서 흡수되는 흡수 선량을 mesh tally로 수집하였고, 4문 조사를 통하여 중첩된 선량에 대한 데이터를 획득하였다. 그와 동시에 EPID에서 물을 투과해 나오는 선량을 획득 한 뒤 역 투사 방법을 사용하여 선량 재구성을 하였다. 이둘의 경우를 비교하기 위해 자체적인 교정(calibration)을 통하여 투과해 나온 선량과 흡수된 선량과의 관계를 비교하고 4문 조사를 통하여 물 팬텀 내의 특정 부분에 대한 중첩된 선량 데이터와 EPID를 통해 재구성한 선량 데이터를 분석하였다. 물 팬텀과 EPID에서 획득한 누적 선량의 합은 각각 평균 3.4580 MeV/g과 3.4354 MeV/g이었다. 이는 앞서 계측된 물 팬텀 내부의 누적 선량과 0.6536% 선량 오차를 보였다.

칠피(漆皮) 추출물의 담도암 세포주 SNU-1079와 SNU-1196에 대한 항암효과 (Study on Anti-Cancer Effects of Rhus Verniciflua Stokes Extracted with Sterile Distilled Water on Two Cholangiocarcinoma Cell Lines, SNU-1079 and SNU-1196)

  • 정보배;김영철
    • 대한한방내과학회지
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    • 제36권1호
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    • pp.1-12
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    • 2015
  • Objectives : This study was performed to investigate the anti-cancer effects of Rhus verniciflua Stokes (RVS) extracted with sterile distilled water on cholangiocarcinoma cell lines. Materials and Methods : Two cholangiocarcinoma cell lines, SNU-1079 and SNU-1196, were used in this study. Cells were treated with different concentrations of RVS for 24, 48, and 72 hours. Cell count, viability, apoptosis, and mRNA expression of Bax, Bcl-2, Mcl-1, survivin, caspase-3, and cyclin D1 and P21 were determined with an automatic cell counter (ADAM-MC), MTT assay, apoptosis assay (Annexin-V/PI staining), and RT-PCR. Results : All cells treated with RVS showed decreased cell counts in a dose-dependent manner. RVS inhibited proliferation of SNU-1196 in a dose-dependent manner, but SNU-1079 proliferation was inhibited in the long-time culture group in a dose-dependent manner. The proportion of early and late-stage apoptotic cells was increased by RVS in a dose-dependent manner in SNU-1196. In contrast, it was increased significantly in SNU-1079 treated with high-dose RVS. After treatment with RVS, the mRNA expression of Bcl-2 was decreased while Bax was increased in SNU-1079. Cyclin D1 mRNA levels were decreased in SNU-1196 in a dose-dependent manner. P21 expression was increased in all cells after the treatment with RVS. Conclusions : RVS appears to have potential as a therapeutic agent for cholangiocarcinoma.

Status of Radiation Dose and Radioactive Contamination due to the Fukushima Accident

  • Baba, Mamoru
    • Journal of Radiation Protection and Research
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    • 제41권2호
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    • pp.133-140
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    • 2016
  • Backgrounds: The accident at Fukushima Daiichi Nuclear Power Plant (NPP), March 2011, caused serious radioactive contamination over wide area in east Japan. Therefore, it is important to know the effect of the accident and the status of NPP. Materials and Methods: This paper provides a review on the status of radiation dose and radioactive contamination caused by the accident on the basis of publicized information. Results and Discussion: Monitoring of radiation dose and exposure dose of residents has been conducted extensively by the governments and various organizations. The effective dose of general residents due to the accident proved to be less than a mSv both for external and internal dose. The equivalent committed dose of thyroid was evaluated to be a few mSv in mean value and less than 50 mSv even for children. Monitoring of radioactivity concentration has been carried out on food ingredients, milk and tap water, and actual meal. These studies indicated the percentage of foods above the regulation standard was over 10% in 2011 but decreasing steadily with time. The internal dose due to foods proved to be tens of ${\mu}Sv$ and much less than that due to natural $^{40}K$ even in the Fukushima area and decreasing steadily, although high level concentration is still observed in wild plants, wild mushrooms, animals and some kind of fishes. Conclusion: According to extensive studies, not only the effect of the accident but also the pathway and countermeasures against radioactive contamination have been revealed, and they are applied very effectively for restoration of environment and reconstruction of the area.

Evaluation of Dynamic Delivery Quality Assurance Process for Internal Target Volume Based RapidArc

  • Song, Ju-Young
    • 한국의학물리학회지:의학물리
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    • 제28권4호
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    • pp.181-189
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    • 2017
  • The conventional delivery quality assurance (DQA) process for RapidArc (Varian Medical Systems, Palo Alto, USA), has the limitation that it measures and analyzes the dose in a phantom material and cannot analyze the dosimetric changes under the motional organ condition. In this study, a DQA method was designed to overcome the limitations of the conventional DQA process for internal target volume (ITV) based RapidArc. The dynamic DQA measurement device was designed with a moving phantom that can simulate variable target motions. The dose distribution in the real volume of the target and organ-at-risk (OAR)s were reconstructed using 3DVH with the ArcCHECK (SunNuclear, Melbourne, USA) measurement data under the dynamic condition. A total of 10 ITV-based RapidArc plans for liver-cancer patients were analyzed with the designed dynamic DQA process. The average pass rate of gamma evaluation was $81.55{\pm}9.48%$ when the DQA dose was measured in the respiratory moving condition of the patient. Appropriate method was applied to correct the effect of moving phantom structures in the dose calculation, and DVH data of the real volume of target and OARs were created with the recalculated dose by the 3DVH program. We confirmed the valid dose coverage of a real target volume in the ITV-based RapidArc. The variable difference of the DVH of the OARs showed that dose variation can occur differently according to the location, shape, size and motion range of the target. The DQA process devised in this study can effectively evaluate the DVH of the real volume of the target and OARs in a respiratory moving condition in addition to the simple verification of the accuracy of the treatment machine. This can be helpful to predict the prognosis of treatment by the accurate dose analysis in the real target and OARs.

유암수술후 방사선치료시 $^{60}Co\;\gamma$선과 전자선 조사야 접합부 선량분포에 관한 연구 (A Study on Dobe Distribution at the Junction of $^{60}CO\;\gamma-Ray$ and Elecron Beam in Postoperative Radiotherapy of Breast Cancer)

  • 강위생;허승재;하성환
    • Radiation Oncology Journal
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    • 제2권1호
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    • pp.149-153
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    • 1984
  • Postoperative radiotherapy of breast cancer makes it possible to reduce loco-regional recurrence of breast cancer. The treatment technique, which can reduce the low-dose region at the junction and lung, is required. To produce proper dose distribution of internal mammary chain and chest wall, authors tried to find the method to expose $^{60}Co\;\gamma-ray$ on internal mammary region and 7MeV electron on chest wall. Exposure time of $^{60}Co\;\gamma$ and monitor unit of 9MeV were selected so that dose of $^{60}Co$ at 4cm depth was the same as that of 7Mev electron at $80\%$ dose depth. The position and direction of electron beam were changed for $^{60}Co$ beam: $0^{\circ},\;5^{\circ}$ for 0cm seperation; $0^{\circ},\;5^{\circ},\;10^{\circ}$ for 0.5cm seperation; $5^{\circ},\;10^{\circ},\;15^{\circ}$ for 1cm seperation. The results are as followings. 1. When the seperation of two fields was increased, dose on the axis of $^{60}Co$ beam was increased and dose at the junction region decreased while the volume of lung to be exposed to high dose and hot spot size were irregularly changed. 2. The dose distribution in the target volume of internal mammary and chest wall was most ideal when the seperation of two fields was $0\~0.5cm$ and the direction of electron beam was parallel to $^{60}Co$ beam.

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Individual Doses to the Public after the Fukushima Nuclear Accident

  • Ishikawa, Tetsuo
    • Journal of Radiation Protection and Research
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    • 제45권2호
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    • pp.53-68
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    • 2020
  • Background: International organizations such as the World Health Organization (WHO) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) reported public exposure doses due to radionuclides released in the Fukushima nuclear accident a few years after the event. However, the reported doses were generally overestimated due to conservative assumptions such as a longer stay in deliberate areas designated for evacuation than the actual stay. After these reports had been published, more realistic dose values were reported by Japanese scientists. Materials and Methods: The present paper reviews those reports, including the most recently published articles; and summarizes estimated effective doses (external and internal) and issues related to their estimation. Results and Discussion: External dose estimation can be categorized as taking two approaches-estimation from ambient dose rate and peoples' behavior patterns-and measurements using personal dosimeters. The former approach was useful for estimating external doses in an early stage after the accident. The first 4-month doses were less than 2 mSv for most (94%) study subjects. Later on, individual doses came to be monitored by personal dosimeter measurements. On the basis of these measurements, the estimated median annual external dose was reported to be < 1 mSv in 2011 for 22 municipalities of Fukushima Prefecture. Internal dose estimation also can be categorized as taking two approaches: estimation from whole-body counting and estimation from monitoring of environmental samples such as radioactivity concentrations in food and drinking water. According to results by the former approach, committed effective dose due to 134Cs and 137Cs could be less than 0.1 mSv for most residents including those from evacuated areas. Conclusion: Realistic doses estimated by Japanese scientists indicated that the doses reported by WHO and UNSCEAR were generally overestimated. Average values for the first-year effective doses for residents in two affected areas (Namie Town and Iitate Village) were not likely to reach 10 mSv, the lower end of the doses estimated by WHO.

THE BIDAS-2007: BIOASSAY DATA ANALYSIS SOFTWARE FOR EVALUATING A RADIONUCLIDE INTAKE AND DOSE

  • Lee, Jong-Il;Lee, Tae-Young;Kim, Bong-Whan;Kim, Jang-Lyul
    • Nuclear Engineering and Technology
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    • 제42권1호
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    • pp.109-114
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    • 2010
  • Bioassay data analysis software (BiDAS-2007) has been developed by KAERI, which adds several new functions to its previous version. New functions of the BiDAS-2007 computer code enable the user not only to do a simultaneous analysis by using two or more types of bioassay for the best internal dose evaluation, but also to do a continual internal dose evaluation from a change of the internal exposure conditions such as an intake type (acute, chronic), an intake pathway (inhalation, ingestion), an absorption type (Type F, M, S), and a particle size (AMAD, activity median aerodynamic diameter), and also to estimate the intakes in various conditions of an internal exposure at a time. The values calculated by the BiDAS-2007 code are consistent and in good agreement with those values by IMIE-2004 code by Berkovski and IMBA code by Birchall. The BiDAS-2007 computer code is very useful and user-friendly to estimate the radionuclide intakes and committed effective doses of a radiation worker.