Conventional high-dose antipsychotics tend to result in more side effects, negative symptoms and dysphoria, and at the same time lower the cognitive function which is already impaired in most schizophrenics. Florid psychotic symptoms, negative symptoms and cognitive impairment greatly impede psychosocial performance and eventual reintegration into society. The reduction of symptom and the improvement of cognitive funtions and social skills are therefore central to the psychiatric rehabilitation process. The purpose of this study was to evaluate the dose-reduction effects of antipsychotics on chronic schizophrenics prescribed conventional high-dose antipsychotics more than 1,500mg equivalent of chlorpromazine. Fifty-one chronic schizophrenics who maintained high-dose antipsychotics for more than three months were randomly assigned to two groups : 20 patients comprised the dose-maintaining group and 31 patients made the dose-reduction group. Over a sixteen weekperiod Positive and Negative Syndrome Scale(PANSS), Extrapyramidal Symptom(EPS), Nurses' Observation Scale for Inpatient Evaluation(NOSIE-30), Continuous Performance Test(CPT), Quality of Life(QOL), and haloperidol/reduced haloperidol blood levels were determined at the base line and after 2, 4, 6, 8, 12, 16 weeks to evaluate the dose reduction effects of high-dose antipsychotics. The results were as follows : 1) Dose-reduction is highly effective in reducing positive and negative symptoms, and general psychopathology. Effects were most prominent at 8, 12, 16 weeks. Among the dose reduction group, positive symptoms in positive symptom group and negative symptoms in negative symptom group were more reduced. 2 Extrapyramidal symptoms showed no significant difference between two groups. But the EPS was reduced time after time within two groups. 3) Hit rates of Continuous Performance Test, which indicate attentional capacity, increased significantly after dose reduction. 4) Haloperidol and reduced haloperidol blood levels decreased until the 4th week, after which they were constant. 5) Total scores of Nurses' Observation Scale for Inpatient Evaluation were unchanged between the two groups. But among the indices, social interest and personal neatness were improved in the dose-reduction group and retardation was aggrevated in the dose-maintaining group. 6) Total quality of life scores were unchanged between two groups. But in the dose maintaining group, satisfaction scores of attention, autonomy, and interpersonal relationship decreased progressively. These findings suggest that the dose reduction of antipsychotics for chronic schizophrenics on programs of high-dose antipsychotics were effective. Dose reduction should therefore be implemanted to spread the rehabilitation and improve quality of life for chronic schizophrenics.
Objective: The aim of this study is to investigate the effective managerial factors influencing dose reduction of the nozzle dam installation and removal tasks ranking within top 3 in viewpoint of average collective dose of nuclear power plant maintenance job. Background: International Commission on Radiation Protection (ICRP) recommended to reduce unnecessary dose and to minimize the necessary dose on the participants of maintenance job in radiation fields. Method: Seven sessions of nozzle dam installation and removal task logs yielded a multiple regression model with collective dose as a dependent variable and work time, number of participants, space doses before and after shield as independent variables. From the sessions in which a significant reduction in collective dose occurred, the effective managerial factors were elicited. Results: Work time was the most important factor contributing to collective dose reduction of nozzle dam installation and removal task. Introduction of new technology in nozzle dam design or maintenance job is the most important factor for work time reduction. Conclusion: With extended task logs and big data processing technique, the more accurate prediction model illustrating the relationship between collective dose reduction and effective managerial factors would be developed. Application: The effective managerial factors will be useful to reduce collective dose of decommissioning tasks as well as regular preventive maintenance tasks for a nuclear power plant.
Annual radiation dose limit to radiation worker was substantially lowered in Korea by the adoption of 1990 recommendations of the International Commission on Radiation Protection (ICRP 60) in its legislation. On the other hand, radiation management environment in nuclear power plants is getting more worse because of the accumulation of radiation sources inside the system and the frequent need for maintenance according as the operation years of nuclear power plants increase. Therefore, Korea Hydro & Nuclear power Co., Ltd. (KHNP) has established a long-term 10 years plan from 2001 to 2010 for the reduction of radiation dose to workers. The plan is aimed for the reduction of annual dose per unit averaged over 5 years from 0.9 man-Sv in 2001 to 0.75 man-Sv in 2010 by radiation source reduction, equipment/tool improvement or new equipment development for easy maintenance, and the improvement of administration and system.
This study analyzed dose reduction and quality of images through dose reduction tools and shielding board to protect sensitive eye lens in radiation during orbit CT examinations for clinical data use. During CT scans of the phantom, surface dose (CT scanner dosimetry phantom, ion chamber-3 times) and quality of image (radiosurgery head phantom, visual assessment-2 times, HU standard deviation) were evaluated using X-care which is dose reduction tools and bismuth shielding board. The results of experiments of eight conditions showed a relatively reduced dose in all other conditions compared to when no conditions were set. In particular, the area corresponding to the ophthalmic part reduced the surface dose by up to 45.7 %. The visual evaluation of images by specialists and the quality evaluation of images analyzed by HU standard deviation were clinically closest to the use of X-care and shielding board (1 cm in height). Therefore, it is believed that the use of shielding board in a suitable location with dose reduction tools while investigating the optimal radiation dose will reduce the exposure dose of sensitive lens at radiation while maintaining the quality of the images with high diagnostic value.
In EVAR procedure using long time C-arm, we studied exposure dose reduction and effeciency through measuring surgical staff's ESD by installing lead curtain operating table next to. The height 3 the spot (50cm, 100cm, 150cm) dose was measured on 2 locations for 600sec in the X-ray radiation considering the surgical staff's movement. To install the curtains, we compared before and after the dose. As a result, it can confirm that dose of the installation former of 50cm height and after is reduced about 75% and 91% in 2 locations. In 100cm height, the reduction of the dose was a bit confirmed. There as to dose value, measured on 150cm height the installation former and after was nearly no change. This research examined the exposure dose about the radiation of the surgical staff during EVAR procedure in which the operation time is the long time. It was implemented in the object that it reduces the radiation exposure. It could confirm the certain effect of the experimental result exposure dose reduction In EVAR procedure using long time C-arm, we studied exposure dose reduction and effeciency through measuring surgical staff's ESD by installing lead curtain operating table next to. The height 3 the spot (50cm, 100cm, 150cm) dose was measured on 2 locations for 600sec in the X-ray radiation considering the surgical staff's movement. To install the curtains, we compared before and after the dose. As a result, it can confirm that dose of the installation former of 50cm height and after is reduced about 75% and 91% in 2 locations. In 100cm height, the reduction of the dose was a bit confirmed. There as to dose value, measured on 150cm height the installation former and after was nearly no change. This research examined the exposure dose about the radiation of the surgical staff during EVAR procedure in which the operation time is the long time. It was implemented in the object that it reduces the radiation exposure. It could confirm the certain effect of the experimental result exposure dose reduction.
Proceedings of the Safety Management and Science Conference
/
2011.11a
/
pp.563-571
/
2011
The purpose of the study was to evaluation of the radiation dose reduction using various automatic exposure control (AEC) systems in different manufactures multi-detector computed tomography (MDCT). We used three different manufacturers for the study: General Electric Healthcare, Philips Medical systems and Siemens Medical Solutions. The general scanning protocol was created for the each examination with the same scanning parameters as many as possible. In the various AEC systems, the evaluation of reduced-dose was evaluated by comparing to fixed mAs with using body phantom. Finally, when we applied to AEC for three manufacturers, the radiation dose reduction decreased each 35.3% in the GE, 58.2% in the Philips, and 48.6% in the Siemens. This applies to variety of the AEC systems which will be very useful to reduce the dose and to maintain the high quality.
Ensuring occupational radiation exposure(ORE) as low as is reasonably achievable(ALARA) has been one of very important requirements in a nuclear power plant. It is well known that about 70 percent of occupational dose has incurred from maintenance jobs in the outage period. To reduce occupational dose effectively, the high-dose jobs in the outage period should be identified with their dose reduction potentials and methods. In this study, a PC-based ORE database program, INSTORE, is developed to evaluate ORE doses in individual jobs, and the ORE data of Kori Units 3 and 4 are assembled to the database. Based on customary job classification, radiation work is classified into 26 main jobs which comprise 61 detailed jobs, and occupational doses are assessed according to each detailed job. As a result, high-dose jobs are identified with dose reduction priority in terms of collective ORE dose. It is recommended that adeqaute dose reduction methods for these jobs should be prepared to improve their working conditions and procedures.
The purpose of this study is to compare the reduction of the dose radioactivity by CARE kV with that of the Bismuth shielding. First, CT was performed with transparent materials, including a Bismuth shielder which is a well-known material for decreasing the dose of radiation. Moreover, we have estimated and compared the affects of the reduction of dose on eye lens, thyroid, breast and genitals. These steps aim to compare reactions with and without the application of the Rando phantom with PLD as well as with CARE kV or not. As a result, during the Brain angio scan, the dose of CARE kV set inspection test methods showed the least dose. Depending on whether we use CARE kV, which showed the effect of dose reduction by 63%. During the Carotid angio scan, the dose was increased by 13% by how to set CARE kV+Bismuth. During the Cardiac angio scan, which showed the effect of dose reduction by 31% by how to set CARE kV+Bismuth. During the Lower extremity angio scan, the dose was measured least by how to set up the whole Bismuth. Compared with CARE kV set of test methods, which showed the effect of dose reduction by 9%.
Purpose : To compare radiation dose for coronary CT angiography (CTA) obtained with 6 examination protocols such as a retrospectively ECG gated helical scan, a prospectively ECG gated sequential scan, low kVp technique, and cardiac dose modulation technique. Materials and Methods : Coronary CTA was performed by using 6 current clinical protocols to evaluate effective dose and organ dose in primary beam area with anthropomorphic female phantom and glass dosimetric system in 64 channel multi-detector CT. After acquiring topograms of frontal and lateral projection with 80 kVp and 10 mA, main coronary scan was done with 0.35 sec tube rotation time, 40 mm collimation ($0.625\;mm{\times}64\;ea$), small scan field of view (32 cm diameter), 105 mm scan length. Heart beat rate of phantom was maintained 60 bpm in ECG gating. In constant mAs technique 120 kVp, 600 mA was used, and 100 kVp for low kVp technique. In a retrospectively ECG gated helical CT technique 0.22 pitch was used, peak mA (600 mA) was adopted in range of $40{\sim}80%$ of R-R interval and 120mA(80% reduction) in others with cardiac dose modulation. And 210 mAs was used without cardiac dose modulation. In a prospectively ECG gated sequential CT technique data were acquired at 75% R-R interval (middle diastolic phase in cardiac cycle), and 120 msec additional padding of the tube-on time was used. For effective dose calculation region specific conversion factor of dose length product in thorax was used, which was recommended by EUR 16262. Results : The mean effective dose for conventional coronary CTA without cardiac dose modulation in a retrospectively ECG gated helical scan was 17.8 mSv, and mean organ dose of heart was 103.8 mGy. With low kVp and cardiac dose modulation the mean effective dose showed 54.5% reduction, and heart dose showed 52.3% reduction, compared with that of conventional coronary CTA. And at the sequential scan(SnapShot pulse mode) under prospective ECG gating the mean effective dose was 4.9 mSv, this represents an 72.5% reduction compared with that of conventional coronary CTA. And heart dose was 33.8 mGy, this represents 67.4% reduction. In the sequential scan technique under prospective ECG gating with low kVp the mean effective dose was 3.0 mSv, this represents an 83.2% reduction compared with that of conventional coronary CTA. And heart dose was 17.7 mGy, this represents an 82.9% reduction. Conclusion : In coronary CTA at retrospectively ECG gated helical scan, cardiac dose modulation technique using low kVp reduced dose to 50% above compared with the conventional helical scan. And the prospectively ECG gated sequential scan offers substantially reduced dose compared with the traditional retrospectively ECG gated helical scan.
Interventional radiology is performed under real-time fluoroscopy, and patients are exposed to a wide range of exposures for a long period of time depending on the examination and procedure. However, studies on radiation protection for patients during an intervention are insufficient. This study aims to evaluate the doses exposed during the intervention and the applicability of 3D printing materials. The organ dose for each intervention site was evaluated using a monte carlo simulatio. Also, the dose reduction effect of the critical organs was calculated when using a shielding device using 3D printing materials. As a result, the organ dose distribution for each intervention site showed a lower dose distribution for organs located far from the x-ray tube. It was analyzed that the influence of scattered rays was higher in the superficial organs of the back of the human body where x-rays were incident. The dose reduction effect on the critical organ using the 3D printing shield showed the highest testis among the gonads, and in the case of other organs, the dose reduction effect gradually decreased in the order of the eye, thyroid, breast, and ovary. Accordingly, it is judged that the 3D printed shield will be sufficiently usable as a shielding device for the radiation protection of critical organs.
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