• Title/Summary/Keyword: Radiation Emergency Medicine

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Study on the Compatibility for an Ir-192 Source Manufactured by Korea Atomic Energy Research Institute (KAERI) in GammaMed Brachytherapy Machine (한국원자력연구소에서 개발한 Ir-192 선원의 감마메드 치료기 호환성 연구)

  • Jeong, Dong-Hyeok;Lee, Kang-Kyoo;Kim, Soo-Kon;Moon, Sun-Rock
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.78-85
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    • 2010
  • The compatibility with GammaMed-12i brachytherapy machine for an Ir-192 encapsulated source (IRRS20, KAERI, Korea) manufactured by Korea atomic energy research institute (KAERI) has been investigated. As a mechanical testing of compatibility, precise measurement of step movement with channels, measurement of curvature of radius for wire, and emergency return testing were performed. Periodic measurements of air kerma strength for 45 days were carried out to evaluate decay characteristics of Ir-192 radioisotope and comparison of dose distributions in phantom between KAERI and old sources previously used were performed by film dosimetry. KAERI source has a good compatibility with GammaMed12i machine as a result of mechanical testing. There are in good agreement with calculated values in activity characteristics and there were small differences in dose distributions around the source in comparison between KAERI and old source.

Determination of Self-Disposal date by the Analysis of Radioactive Waste Contamination for 1131I Therapy Ward (131I 치료입원실 폐기물 방사능 오염도 분석 및 자체처분가능일자 산출)

  • Kim, Gi-sub;Jung, Haijo;Park, Min-seok;Jeon, Gjin-seong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.3-6
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    • 2013
  • Purpose: The treatment of thyroid cancer patients was continuously increased. According to the increment of thyroid cancer patients, the establishment of iodine therapy site was also increased in each hospital. This treatment involves the administration of radioactive iodine, which will be given in the form of a capsule. Therefore, protections and managements for radioactive source pollution and radiation exposure should be necessary for radiation safety. Among the many problems, the problem of disposing the radioactive wastes was occurred. In this study, The date for self-disposal for radioactive wastes, which were contaminated in clothes, bedclothes and trash, were calculated. Materials and Methods: The number of iodine therapy ward was 15 in Korea Institute of Radiological Medical and Sciences. Recently, 8 therapy wards were operated for iodine therapy patients and others were on standby for emergency treatment ward of any radiation accidents. Radioactive wastes, which were occurred in therapy ward, were clothes, bedclothes, bath cover for patients washing water and food and drink which was leftover by patients. Each sample was hold into the marinelli beaker (clothes, bedclothes, bath covers) and 90 ml beaker (food, drink, and washing water). The activities of collected samples were measured by HpGe MCA device (Multi Channel Analysis, CANBERRA, USA) Results: The storage period for the each kind of radioactive wastes was calculated by equation of storage periods based on the measurement outcomes. The average storage period was 60 days for the case of clothes, and the maximum storage period was 93 days for patient bottoms. The average storage period and the maximum storage period for the trash were 69 days and 97 days, respectively. The leftover foods and drinks had short storage period (the average storage period was 25 days and maximum storage period was 39 days), compared with other wastes. Conclusion: The proper storage period for disposing the radioactive waste (clothes, bedclothes and bath cover) was 100 days by the regulation on self-disposal of radioactive waste. In addition, the storage period for disposing the liquid radioactive waste was 120 days. The current regulation for radioactive waste self-disposing was not suitable for the circumstances of each radioactive therapy facility. Therefore, it was necessary to reduce the leftover food and drinks by adequate table setting for patients, and improve the process and regulation for disposing the short-half life radioactive wastes.

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Public Exposure to Natural Radiation and the Associated Increased Risk of Lung Cancer in the Betare-Oya Gold Mining Areas, Eastern Cameroon

  • Joseph Emmanuel Ndjana Nkoulou II;Louis Ngoa Engola;Guy Blanchard Dallou;Saidou;Daniel Bongue;Masahiro Hosoda;Moise Godefroy Kwato Njock;Shinji Tokonami
    • Journal of Radiation Protection and Research
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    • v.48 no.2
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    • pp.59-67
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    • 2023
  • Background: This study aims to reevaluate natural radiation exposure, following up on our previous study conducted in 2019, and to assess the associated risk of lung cancer to the public residing in the gold mining areas of Betare-Oya, east Cameroon, and its vicinity. Materials and Methods: Gamma-ray spectra collected using a 7.62 cm×7.62 cm in NaI(Tl) scintillation spectrometer during a car-borne survey, in situ measurements and laboratory measurements performed in previous studies were used to determine the outdoor absorbed dose rate in air to evaluate the annual external dose inhaled by the public. For determining internal exposure, radon gas concentrations were measured and used to estimate the inhalation dose while considering the inhalation of radon and its decay products. Results and Discussion: The mean value of the laboratory-measured outdoor gamma dose rate was 47 nGy/hr, which agrees with our previous results (44 nGy/hr) recorded through direct measurements (in situ and car-borne survey). The resulting annual external dose (0.29±0.09 mSv/yr) obtained is similar to that of the previous study (0.33±0.03 mSv/yr). The total inhalation dose resulting from radon isotopes and their decay products ranged between 1.96 and 9.63 mSv/yr with an arithmetic mean of 3.95±1.65 mSv/yr. The resulting excess lung cancer risk was estimated; it ranged from 62 to 216 excess deaths per million persons per year (MPY), 81 to 243 excess deaths per MPY, or 135 excess deaths per MPY, based on whether risk factors reported by the U.S. Environmental Protection Agency, United Nations Scientific Committee on the effects of Atomic Radiation, or International Commission on Radiological Protection were used, respectively. These values are more than double the world average values reported by the same agencies. Conclusion: There is an elevated level of risk of lung cancer from indoor radon in locations close to the Betare-Oya gold mining region in east Cameroon. Therefore, educating the public on the harmful effects of radon exposure and considering some remedial actions for protection against radon and its progenies is necessary.

Analysis of Factors which Affect the Medical Utilization Fee after an Increase of Health Insurance Benefits for Patients with Serious Illnesses (건강보험 중증질환 급여확대 전후에 따른 진료비 차이에 관한연구)

  • Lee, Jung-He;Lee, Moo-Sik;Kim, Jee-Hee;Moon, Tae-Young;Kim, Yong-Ha;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.4
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    • pp.1504-1510
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    • 2010
  • According to a research analysis of the factors which affect the medical utilization fee after an increase of health insurance benefits for patients with serious illnesses based on 225 patients over 6 months, both before and after the increase of benefits, from January, 1st, 2005 to June 30th, and also from January, 1st, 2006 to June 30th. In terms of genders, 67.8% of males were affected, whereas only 32.2% of females were effected, a much higher rate of men than women. Men also had higher rates before and after the increase of benefits. Out of 5 categories related to medication and treatment, radiation testing was the most expensive at about 5,300,000, operation fees were 590,000, and costs of other testing approximately 200,000 with the least expensive category being 120,000 for medication. By looking at the relationship between the fees and increase of benefits, medication was a hospital charge (p<0.01), injection fees were hospital charges (p<0.01), operation fees were hospital charges (p<0.01). Medication fees (p<0.01) and injection fees (p<0.01) were found to be related.

Radiotherapy for Brain Metastases in Southern Thailand: Workload, Treatment Pattern and Survival

  • Phungrassami, Temsak;Sriplung, Hutcha
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1435-1442
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    • 2015
  • Purpose: To study the patient load, treatment pattern, survival outcome and its predictors in patients with brain metastases treated by radiotherapy. Materials and Methods: Data for patients with brain metastases treated by radiotherapy between 2003 and 2007 were collected from medical records, the hospital information system database, and a population-based tumor registry database until death or at least 5 years after treatment and retrospectively reviewed. Results: The number of treatments for brain metastases gradually increased from 48 in 2003 to 107 in 2007, with more than 70% from lung and breast cancers. The majority were treated with whole brain radiation of 30 Gy (3 Gy X 10 fractions) by cobalt-60 machine, using radiation alone. The overall median survival of the 418 patients was 3.9 months. Cohort analysis of relative survival after radiotherapy was as follows: 52% at 3 months, 18% at 1 year and 3% at 5 years in males; and 66% at 3 months, 26% at 1 year and 7% at 5 years in females. Multivariate analysis demonstrated that the patients treated with combined modalities had a better prognosis. Poor prognostic factors included primary cancer from the lung or gastrointestinal tract, emergency or urgent consultation, poor performance status (ECOG 3-4), and a hemoglobin level before treatment of less than 10 g/dl. Conclusions: This study identified an increasing trend of patient load with brain metastases. Possible over-treatment and under-treatment were demonstrated with a wide range of survival results. Practical prognostic scoring systems to assist in decision-making for optimal treatment of different patient groups is absolutely necessary; it is a key strategy for balancing good quality of care and patient load.

The presence of carcinogenic radon in the Padma River water, adjacent to the Rooppur Nuclear Power Plant

  • M.M. Mahfuz Siraz;M.S. Alam;Jubair A.M.;S.C. Das;J. Ferdous;Z. Hossain;S. Das;Mayeen Uddin Khandaker;D.A. Bradley;Shinji Tokonami;S. Yeasmin
    • Nuclear Engineering and Technology
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    • v.55 no.8
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    • pp.3046-3053
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    • 2023
  • Radon is a naturally occurring carcinogenic agent, poses a serious health hazard when inhaled or ingested in significant amounts. The water of the Padma river will be used as a tertiary coolant for the soon-to-be-commissioned 'Rooppur Nuclear Power Plant'. Hence, it is important to assess the radiological status of the river prior to the commission of this power plant. Therefore, for the first time, 25 samples of water were collected from various locations of the Padma River and analyzed for radon concentration using the RAD H2O (DURRIDGE) radon monitoring device. The radon concentrations were found in the range from 0.077 ± 0.036 to 0.494 ± 0.211 Bq/L with a mean of 0.250 ± 0.093 Bq/L. All the concentrations were found to be below the recommended limits of WHO (100 Bq/L) and USEPA (11.1 Bq/L). The mean annual effective dose due to the radon exposure via inhalation and ingestion pathways were 0.638 µSv/y and 0.629 µSv/y, respectively, which were all well below the annual effective dose recommended by WHO (0.1 mSv/y). Since Bangladesh lacks a national safety limit of radon in water, this pioneering study provides baseline data on radon levels for the environment around Rooppur Nuclear Power Plant.

A Case of Dural Arteriovenous Fistula of Superior Sagittal Sinus after Tamoxifen Treatment for Breast Cancer

  • Hwang, Sung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.57 no.3
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    • pp.204-207
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    • 2015
  • We are reporting an unusual case of dural arteriovenous fistula (AVF) of the superior sagittal sinus (SSS) after tamoxifen treatment for breast cancer. A 30-year-old female arrived at the emergency room with a sudden headache and left sided weakness and sensory loss. In her past medical history, she was diagnosed with breast cancer 1 year prior, and subsequently underwent a breast conserving mastectomy with whole breast radiation and adjuvant chemotherapy with tamoxifen. At the time of admission, computed tomography showed a small acute intracerebral hemorrhage at the right parietal cortex, and magnetic resonance imaging showed that a dural AVF at the SSS with a prominent and tortuous venous enhancement along the centrum semiovale was present. Cerebral angiography showed that the dural AVF at the mid-portion of the SSS with meningeal arterial feeding vessels entering the wall of the SSS, then draining through the dilated cortical veins. Our patient had no signs of active malignancy or any abnormalities in her coagulation profile, so it can be concluded that the tamoxifen was the likely cause of the SSS thrombosis and dural AVF. The dural AVF was treated by an endovascular coil embolization for the arterialized segment of the SSS. The patient dramatically recovered favorably from left side motor and sensory deficit. The best clinical approach is to screen potential patients of tamoxifen hormonal therapy and educate them on the sign and symptoms of life threatening thromboembolic events while taking tamoxifen.

The Competency in Disaster Nursing of Korean Nurses: Scoping Review (국내 간호사의 재난간호 역량: 주제범위 문헌고찰)

  • Lee, Eunja;Yang, Jungeun
    • Journal of East-West Nursing Research
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    • v.27 no.2
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    • pp.153-165
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    • 2021
  • Purpose: The aim of study was to identify ranges of Korean nurses' competency in disaster nursing. Methods: A scoping review was conducted using the Joanna Briggs Institute methodology. The review used information from four databases: RISS, ScienceON, EBSCO Discovery Service, and CINAHL. In this review, key words were 'disaster', 'nurs*', 'competenc*', 'ability' and 'preparedness'. Inclusion and exclusion criteria were identified as strategies to use in this review. The inclusion criteria for this review focused on the following: Korean nurse, articles related to disaster nursing competency, peer-review articles published in the full text in Korean and English. Review articles were excluded. Results: Nineteen studies were eligible for result extraction. A total of 10 categories of disaster nursing competency were identified: Knowledge of disaster nursing, crisis management, disaster preparation, information collection and sharing, nursing record and document management, communication, disaster plan, nursing activities in disaster response, infection management, and chemical, biological, radiation, nuclear, and explosive management. Conclusion: It is necessary to distinguish between Korean nurses' common disaster nursing competency, professional disaster nursing competency, and disaster nursing competency required in nursing practice. Therefore, future research will be needed to explore and describe disaster nursing competency.

Endovascular embolization of persistent liver injuries not responding to conservative management: a narrative review

  • Simon Roh
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.165-171
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    • 2023
  • Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

A Case of Coronary-Pulmonary Artery Fistula (관상동맥-폐동맥 누공 1예)

  • Lee, Kyung Hae;Wang, Joon Kwang;Shin, Sung Joon;Kim, Mi Ok;Kim, Tae Hyung;Son, Jang Won;Yun, Ho Ju;Shin, Dong Ho;Park, Sung Soo;Kim, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.420-425
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    • 2004
  • Fistula between coronary artery and pulmonary artery is a type of coronary artery anomalies. It can cause atypical chest pain and fatigue, angina pectoris, endocarditis, finally myocardial steal can result in heart failure and myocardial infarction. But only 0.1-0.2% of coronary angiographic studies reveal the communications between coronary artery and other spaces. (heart chamber, pulmonary artery etc.) It is frequently congenital, but acquired types are increasing because chest and heart manipulations such as opertion of tetralogy of Fallot, endomyocardial biopsy, radiation therapy, or penetrating blunt trauma are increasing. There are reports about repair of fistula using thrombogenic tips, coil embolization and surgical intervention. We report a connection between coronary artery and pulmonary artery in 79 years old female. She was 30 pack-years smoker and suffered from dyspnea several years with chronic obstructive pulmonary disease. She presented with atypical chest pain and palpitation after admission. Electrocardiography showed ST-T wave abnormality. Emergency coronary angiography and chest CT scan revealed coronary-pulmonary artery fistula. Transcatheter embolization was performed and she was relieved from discomforts.