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Sample records for thoracic radiation injury

  1. Interphase death and repair of radiation injuries to thoracic aorta endothelium of mammals

    International Nuclear Information System (INIS)

    Shcherbova, E.N.; Ivanov, Yu.V.

    1978-01-01

    Using the method of plane preparations injury to the thoracic aorta endothelium of guinea-pigs, rats and rabbits exposed to various doses of γ-rays ( 60 Co) has been studied. The value of the threshold dose, tested by diminution of the endothelial cell quantity, has been found to be 250 R for guinea-pigs, 830 R, for rats and 880 R, for rabbits. It has been shown by means of the fractionated irradiation model that the interphase endothelial cells of guinea-pigs and rats can recover from sublethal radiation injuries

  2. The reported thoracic injuries in Homer's Iliad

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    Apostolaki Mary

    2010-11-01

    Full Text Available Abstract Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%, the stones (7.4%, the arrow (5.5% and the sword (5.5%. We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim, medium (those which cause the victim to abandon the battlefield, and severe (those which cause death of the victim. According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95% and the remaining 8 an Achaean (21.05%. The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield.

  3. The reported thoracic injuries in Homer's Iliad.

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    Apostolakis, Efstratios; Apostolaki, Georgia; Apostolaki, Mary; Chorti, Maria

    2010-11-19

    Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%), the stones (7.4%), the arrow (5.5%) and the sword (5.5%). We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim), medium (those which cause the victim to abandon the battlefield), and severe (those which cause death of the victim). According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95%) and the remaining 8 an Achaean (21.05%). The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield.

  4. Imaging after radiation therapy of thoracic tumors

    International Nuclear Information System (INIS)

    Ghaye, B.; Wanet, M.; El Hajjam, M.

    2016-01-01

    Radiation-induced lung disease (RILD) is frequent after therapeutic irradiation of thoracic malignancies. Many technique-, treatment-, tumor- and patient-related factors influence the degree of injury sustained by the lung after irradiation. Based on the time interval after the completion of the treatment RILD presents as early and late features characterized by inflammatory and fibrotic changes, respectively. They are usually confined to the radiation port. Though the typical pattern of RILD is easily recognized after conventional two-dimensional radiation therapy (RT), RILD may present with atypical patterns after more recent types of three or four-dimensional RT treatment. Three atypical patterns are reported: the modified conventional, the mass-like and the scar-like patterns. Knowledge of the various features and patterns of RILD is important for correct diagnosis and appropriate treatment. RILD should be differentiated from recurrent tumoral disease, infection and radiation-induced tumors. Due to RILD, the follow-up after RT may be difficult as response evaluation criteria in solid tumours (RECIST) criteria may be unreliable to assess tumor control particularly after stereotactic ablation RT (SABR). Long-term follow-up should be based on clinical examination and morphological and/or functional investigations including CT, PET-CT, pulmonary functional tests, MRI and PET-MRI. (authors)

  5. Dose effect relationships in cervical and thoracic radiation myelopathies

    International Nuclear Information System (INIS)

    Holdorff, B.

    1980-01-01

    The course and prognosis of radiation myelopathies are determined by 3 factors: the segmental (vertical) location of the lesion, the extent of the transverse syndrome (complete or incomplete) and the radiation dose. The median spinal dose in cervical radiation myelopathies with fatal outcome was higher than in survivals with an incomplete transverse syndrome. In thoracic radiation myelopathies a dose difference between complete and incomplete transverse syndromes could be found as well. Incomplete transverse syndromes as submaximum radiation injuries are more suitable for the determination of the spinal tolerance dose than complete transverse syndromes. The lowest threshold could be stated for cases following high-volume irradiation of the lymphatic system. (Auth.)

  6. Radiation injury

    International Nuclear Information System (INIS)

    Hubner, K.F.

    1988-01-01

    Radiation accidents and incidents continue to be of great interest and concern to the public. Issues such as the threat of nuclear war, the Chernobyl reactor accident, or reports of sporadic incidences of accidental radiation exposure keep this interest up and maintain a high level of fear among the public. In this climate of real concern and radiation phobia, physicians should not only be prepared to answer questions about acute or late effects of ionizing radiation, but also be able to participate in the initial assessment and management of individuals who have been exposed to ionizing radiation or contaminated with radioactive material. Some of the key facts about radiation injury and its medical treatment are discussed by the author

  7. Traumatic injuries: imaging of thoracic injuries

    International Nuclear Information System (INIS)

    Gavelli, G.; Canini, R.; Bertaccini, P.; Battista, G.; Bna, C.; Fattori, R.

    2002-01-01

    Chest trauma is one of the most important causes of death, in particular in individuals under the age of 40 years. The mortality rate for chest trauma, often related to motor vehicle accidents, is approximately 15.5%; it increases dramatically to 77% with associated shock and head injury (Glasgow scores of 3-4). The accurate diagnosis of pathologies consequent to blunt chest trauma depends on a complete knowledge of the different clinical and radiological manifestations. The first diagnostic approach is classically based on chest X-ray often carried out on supine position at the hospital admission. A CT study must then be performed in all chest trauma patients in whom there is even the smallest diagnostic doubt on plain film. In particular, spiral CT (SCT) assumes a fundamental role in the demonstration of mediastinal hemorrhage and direct signs of aortic lesions. At present, SCT is routinely part of a diagnostic evaluation which also includes scans of the brain and the abdomen in polytraumatized patients. Magnetic resonance is the ideal method for visualizing diaphragmatic lesions. Furthermore, recent reports have demonstrated the high diagnostic value of MR in evaluating aortic injuries. The purpose of this article is to review the most common radiological patterns related to chest trauma. (orig.)

  8. Anaesthetic and critical care management of thoracic injuries.

    Science.gov (United States)

    Round, J A; Mellor, A J

    2010-09-01

    Thoracic wounding has been a relatively common presentation of military wounds throughout modern conflict. When civilian casualties are included the incidence has remained constant at around 10%, although the frequency and severity of wounds to combatants has been altered by modern body armour. Whilst thoracic injury has a high initial mortality on the battlefield, those surviving to reach hospital frequently have injuries that only require simple management. In addition to penetrating ballistic injury, blunt chest trauma frequently occurs on operations as a result of road traffic collisions or tertiary blast injury. The physiological impact of thoracic wounds, however, is often great and survivors often require intensive care management and, where available, complex strategies to ensure oxygenation and carbon dioxide removal. This review examines the incidence and patterns of thoracic trauma and looks at therapeutic options for managing these complex cases.

  9. Radiation therapy of thoracic and abdominal tumors

    International Nuclear Information System (INIS)

    LaRue, S.M.; Gillette, S.M.; Poulson, J.M.

    1995-01-01

    Until recently, radiotherapy of thoracic and abdominal tumors in animals has been limited. However, the availability of computerized tomography and other imaging techniques to aid in determining the extent of tumor, an increase in knowledge of dose tolerance of regional organs, the availability of isocentrically mounted megavoltage machines, and the willingness of patients to pursue more aggressive treatment is making radiation therapy of tumors in these regions far more common. Tumor remission has been reported after radiation therapy of thymomas. Radiation therapy has been used to treat mediastinal lymphoma refractory to chemotherapy, and may be beneficial as part of the initial treatment regimen for this disease. Chemodectomas are responsive to radiation therapy in human patients, and favorable response has also been reported in dogs. Although primary lung tumors in dogs are rare, in some cases radiation therapy could be a useful primary or adjunctive therapy. Lung is the dose-limiting organ in the thorax. Bladder and urethral tumors in dogs have been treated using intraoperative and external-beam radiation therapy combined with chemotherapy. These tumors are difficult to control locally with surgery alone, although the optimal method of combining treatment modalities has not been established. Local control of malignant perianal tumors is also difficult to achieve with surgery alone, and radiation therapy should be used. Intraoperative radiation therapy combined with external-beam radiation therapy has been used for the management of metastatic carcinoma to the sublumbar lymph nodes. Tolerance of retroperitoneal tissues may be decreased by disease or surgical manipulation

  10. Blunt Cardiac Injury in Trauma Patients with Thoracic Aortic Injury

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    Rathachai Kaewlai

    2011-01-01

    Full Text Available Trauma patients with thoracic aortic injury (TAI suffer blunt cardiac injury (BCI at variable frequencies. This investigation aimed to determine the frequency of BCI in trauma patients with TAI and compare with those without TAI. All trauma patients with TAI who had admission electrocardiography (ECG and serum creatine kinase-MB (CK-MB from January 1999 to May 2009 were included as a study group at a level I trauma center. BCI was diagnosed if there was a positive ECG with either an elevated CK-MB or abnormal echocardiography. There were 26 patients (19 men, mean age 45.1 years, mean ISS 34.4 in the study group; 20 had evidence of BCI. Of 52 patients in the control group (38 men, mean age 46.9 years, mean ISS 38.7, eighteen had evidence of BCI. There was a significantly higher rate of BCI in trauma patients with TAI versus those without TAI (77% versus 35%, P<0.001.

  11. The role of diagnostic VATS in penetrating thoracic injuries

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    Guasti Guido

    2006-10-01

    Full Text Available Abstract Background Penetrating chest injuries account for 1–13% of thoracic trauma hospital admissions and most of these are managed with a conservative approach. Nevertheless, 18–30% of cases managed only with tube thoracostomy have residual clotted blood, considered the major risk factor for the development of fibrothorax and empyema. In addition, 4–23% of chest injury patients present persistent pneumothorax and 15–59% present an injury to the diaphragm, which is missed in 30% of cases. In order to make a correct diagnosis, reduce the number of missed injuries, chronic sequelae and late mortality we propose performing surgical exploration of all patients with a penetrating injury of the pleural cavity. Methods 1270 patients who sustained thoracic trauma were admitted to our hospital between 1994 and 2004. Of these, 16 patients had penetrating injuries: thirteen were surgically explored by means of Video Assisted Thoracic Surgery (VATS, and 3 with thoracotomy due to hemodynamic instability or suspected lesion of the heart or great vessels. Results In the 13 patients who underwent VATS, 5 injuries to the diaphragm, 3 lesions to an intercostal artery, and 1 lesion to the diaphragmatic artery were detected. In 12 of these patients a laceration of the pulmonary parenchyma was also present. A conversion to thoracotomy was necessary due to a broad laceration of the diaphragm and due to hemostasis of an intercostal artery. In all but one case, which was later converted, diagnostic imaging missed the diagnosis of laceration of the diaphragm. There was no intra- or postoperative mortality, and average hospital stay was five days. Conclusion VATS is a safe and effective way to diagnose and manage penetrating thoracic injuries, and its extensive use leads to a reduction in the number of missed, potentially fatal lesions as well as in chronic sequelae.

  12. Rib fractures in blunt chest trauma - associated thoracic injuries

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    Iv. Dimitrov

    2017-09-01

    Full Text Available PURPOSE. The aim of our retrospective study was to analyze the patterns of associated thoracic injuries in patients underwent blunt chest trauma and rib fractures. METHODS. The study included 212 patients with rib fractures due to blunt thoracic trauma. The mechanism of trauma, the type of rib fracture and the type of associated injuries were analyzed. RESULTS. The patients were divided in two groups according to the number of fractured ribs-group I included the patients with up to two fractured ribs (72 patients-33,9%, and group II – with ≥3 fractured ribs (140 patients-66,1%. Associated chest injuries were present in 36 of the patients from group I (50%, and in 133 patients from group II (95%. Pulmonary contusion was the most common intrathoracicinjurie-65,6% of the cases. The mean hospital stay was 8, 7 days. The lethality rate was 16,9% -all of them due to the associated chest injuries. CONCLUSIONS. The mortality related to rib fractures is affected by the associated thoracic injuries, the advanced age, and the number of fractured ribs.

  13. Chemical and radiation injuries

    International Nuclear Information System (INIS)

    Hugo, M.J.

    1981-01-01

    The paper is a discussion of radiation injuries and the treatment thereof. Radiation injuries are mainly caused as a result of nuclear leaks or nuclear bomb explosions. Such an explosion is usually accompanied by a light flash, noise, heat radiation and nuclear radiation which can all caurse various types of injuries. The general effect of radioactive radiation is discussed. The seriousness of the situation where the whole body was exposed to nuclear radiation, depends on the total radiation dose received and varies from person to person. The progress of radiation sickness is described. Mention is also made of long term radiation effects. The emergency treatment of the injured before specialised aid is available, is discussed. The primary aim of treatment is to save life and to prevent further injuries and complications. Injured people must be removed as far as possible from the point of maximum radiation. Attention must also be given to decontamination

  14. Traumatic thoracic injury: the role of Multidetector-row CT

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    Park, Kyung Joo; Kang, Doo Kyung; Kim, Tae Hee [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2006-05-15

    The introduction of Multidetector-row CT (MDCT) has revolutionized the diagnostic strategy of multitrauma patients. The rapid acquisition of a large scanning volume with a thin slice collimation allows for motion-free images of high spatial resolution, and this enables the application of the multiplanar reformat (MPR) and 3D volume-rendering (VR) images. The MPR images more accurately demonstrate aortic rupture or dissection, diaphragmatic injuries and fracture of vertebrae, sternum and costal cartilages. Diagnosing vascular injuries can be aided by using the MIP images. Rib fracture, trachea and bronchial laceration are more easily detected by the 3D images, while airway and vascular injuries can be detected from performing virtual endoscopy. We introduce our current CT imaging protocol and we present our clinical experience with using MDCT in the assessment of patients with blunt thoracic trauma.

  15. Injury by ionizing radiations

    International Nuclear Information System (INIS)

    Upton, A.C.

    1985-01-01

    In view of the vast amount of effort devoted to the study of radiation injury during the past century, it may be concluded that the effects of radiation are better understood than those of any other physical or chemical agent. To this extent, it is useful to review our experience with radiation in addressing health problems associated with other environmental agents

  16. Radiation dose-reduction strategies in thoracic CT.

    Science.gov (United States)

    Moser, J B; Sheard, S L; Edyvean, S; Vlahos, I

    2017-05-01

    Modern computed tomography (CT) machines have the capability to perform thoracic CT for a range of clinical indications at increasingly low radiation doses. This article reviews several factors, both technical and patient-related, that can affect radiation dose and discusses current dose-reduction methods relevant to thoracic imaging through a review of current techniques in CT acquisition and image reconstruction. The fine balance between low radiation dose and high image quality is considered throughout, with an emphasis on obtaining diagnostic quality imaging at the lowest achievable radiation dose. The risks of excessive radiation dose reduction are also considered. Inappropriately low dose may result in suboptimal or non-diagnostic imaging that may reduce diagnostic confidence, impair diagnosis, or result in repeat examinations incurring incremental ionising radiation exposure. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. Potential Long-Term Complications of Endovascular Stent Grafting for Blunt Thoracic Aortic Injury

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    Larry E. Miller

    2012-01-01

    Full Text Available Blunt thoracic aortic injury (BTAI is a rare, but lethal, consequence of rapid deceleration events. Most victims of BTAI die at the scene of the accident. Of those who arrive to the hospital alive, expedient aortic intervention significantly improves survival. Thoracic endovascular aortic repair (TEVAR has been accepted as the standard of care for BTAI at many centers, primarily due to the convincing evidence of lower mortality and morbidity in comparison to open surgery. However, less attention has been given to potential long-term complications of TEVAR for BTAI. This paper focuses on these complications, which include progressive aortic expansion with aging, inadequate stent graft characteristics, device durability concerns, long-term radiation exposure concerns from follow-up computed tomography scans, and the potential for (Victims of Modern Imaging Technology VOMIT.

  18. Radiation injuries/ionizing radiation

    International Nuclear Information System (INIS)

    Gooden, D.S.

    1991-01-01

    This book was written to aid trial attorneys involved in radiation litigation. Radiologists and medical physicists will also find it helpful as they prepare for trial, either as a litigant or an expert witness. Two chapters present checklists to guide attorneys for both plaintiffs and defendants. Gooden titles these checklists Elements of Damages and Elements of Proof and leads the reader to conclusions about each of these. One section that will be particularly helpful to attorneys contains sample interrogatories associated with a case of alleged radiation exposure resulting in a late radiation injury. There are interrogatories for the plaintiff to ask the defendant and for the defendant to ask the plaintiff

  19. Changes in the Severity and Injury Sources of Thoracic Aorta Injuries due to Vehicular Crashes

    OpenAIRE

    Ryb, Gabriel; Dischinger, Patricia; Kerns, Timothy; Burch, Cynthia; Rabin, Joseph; Ho, Shiu

    2013-01-01

    Research using the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) suggested a decreased adjusted risk of thoracic aorta injuries (TAI) for newer vehicles during near-side crashes and an increased adjusted TAI risk during frontal crashes. This study attempted to explore possible explanations of these findings. Adult front seat occupants in the Crash Injury Research and Engineering Network (CIREN) database through June 2012 were studied. TAI cases were compared with ...

  20. An unusual presentation of whiplash injury: long thoracic and spinal accessory nerve injury

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    Omar, N.; Srinivasan, M. S.

    2007-01-01

    Whiplash injuries from motor vehicle accidents are very common. The usual presentation and course of this condition normally results in resolution of symptoms within a few weeks. Brachial plexus traction injuries without any bone or joint lesion of the cervical spine have been reported before. We report a case where a gentleman was involved in a rear end vehicle collision, sustained a whiplash injury and was later found to have a long thoracic nerve palsy and spinal accessory nerve palsy. Although isolated injuries of both nerves following a whiplash injury have been reported, combined injury of the two nerves following a whiplash injury is very uncommon and is being reported for the first time. PMID:17587067

  1. General aspects of radiation injury

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    Kitabatake, T [Niigata Univ. (Japan). School of Medicine

    1974-12-01

    Radiation injury in living organisms was discussed. Physical effects of nuclear irradiation fell into two categories: early effects and late effects. The former occurred invariably by nuclear irradiation above a certain dose, but the latter occurred according to the probability based on the exposure dosage. Late effects included cancer and leukemia which had no specific pathology as compared with non-irradiation induced or leukemia, and their latent periods were long. Because of difficulty in clarifying the cause-and-effect relationship, etiological studies such as McKenzie's or Myrden's, were required. In their studies on the relationship between fluoroscopy and thoracic malignant tumors, prognoses of pulmonary tuberculosis patients who had or had not received multiple fluoroscopies during artificial pneumothorax treatment were followed. The results showed no significant difference between the two groups of patients. Nuclear radiation induced leukemia corresponded to the exposure dose. According to that, exposure dosage of radiological workers was reduced yearly. The latent period of people having low exposure was comparatively prolonged. Medical exposure in radiation therapy was confined to the affected areas and to a small number of patients, although the exposure dose was high. On the other hand, exposure for medical diagnosis was criticized because in spite of its low exposure dose, the exposed population was extremely large.

  2. Comparison of British Thoracic Society and American Thoracic Society reintroduction guidelines for anti-tuberculous therapy induced liver injury

    International Nuclear Information System (INIS)

    Zuberi, B. F.; Alvi, H.; Zuberi, F. F.; Salahuddin, J.

    2014-01-01

    Objective: To compare the efficacy of British Thoracic Society and American Thoracic Society guidelines for re-introduction of anti-tuberculous therapy after drug-induced liver injury, and to assess the ease of administration of each guideline on a scale of 1-10. Methods: The randomised prospective interventional study was conducted at the Department of Medicine and Pulmonology, Dow University of Health Sciences, Karachi, from December 2011 to November 2013. Patients with anti-tuberculous therapy drug-induced liver injury were selected. Hepatotoxic anti-tuberculous therapy was stopped and modified anti-tuberculous therapy was started. Patients were followed weekly till clinical and biochemical parameters got stabilised. After stabilisation, the patients were randomised to one of the two groups to receive re-introduction of anti-tuberculous therapy under the guidelines of British Thoracic Society (Group I) or those of American Thoracic Society (Group II). Means of the groups were analysed by Student's t test and proportions were compared by chi-square test. Multivariate analysis was done for age, body mass index and serum albumin for recurrence of drug-induced liver injury after the re-introduction. P value <0.05 was taken as significant. Results: Of the total 325 patients, 163(50.15%) were in Group I, while 162(49.84%) were in Group II. The frequency of recurrence of drug-induced liver injury in Group I was 16 (9.8%) and in Group II it was 18 (11.1%). There was no statistically significant difference between the two groups (p<0.7). Age was positively related with drug-induced liver injury, while body mass index and serum albumin were negatively associated. Conclusion: There was no significant difference between the two major guidelines though the American Thoracic Society guideline was easier to follow. (author)

  3. Radiation Injury to the Brain

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    ... Hits since January 2003 RADIATION INJURY TO THE BRAIN Radiation treatments affect all cells that are targeted. ... fractions, duration of therapy, and volume of [healthy brain] nervous tissue irradiated influence the likelihood of injury. ...

  4. [Bony injuries of the thoracic cage in multiple trauma : Incidence, concomitant injuries, course and outcome].

    Science.gov (United States)

    Schulz-Drost, S; Oppel, P; Grupp, S; Krinner, S; Langenbach, A; Lefering, R; Mauerer, A

    2016-12-01

    Thoracic trauma is considered to be responsible for 25 % of fatalities in multiple trauma and is a frequent injury with an incidence of 50 %. In addition to organ injuries, severe injuries to the bony parts of the thorax also occur and these injuries are described very differently mostly based on single center data. The focus of this study was on a holistic presentation of the prevalence and the incidence of thoracic trauma in patients with multiple trauma from the data of the large collective of the TraumaRegister DGU® (TR-DGU) with the objective of an analysis of concomitant injuries, therapy options and outcome parameters. A retrospective analysis was carried out based on the data set of the TR-DGU from the years 2009-2013. Inclusion criteria were an injury severity scale (ISS) score ≥ 16 and primary admission to a trauma center but isolated craniocerebral injury was an exclusion criterium. Patients were separated into two groups: those with rib fractures (RF) and those with flail chest (FC). A total of 21,741 patients met the inclusion criteria including 10,474 (48.2 %) suffering from either RF or FC. The mean age was 49.8 ± 19.9 years in the RF group and 54.1 ± 18.2 years in the FC group. Approximately 25 % were female in both groups, 98.1 % were blunt force injuries and the median ISS was 28.0 ± 11.2 in RF and 35.1 ± 14.2 in FC. Shock, insertion of a chest tube, (multi) organ failure and fatality rates were significantly higher in the FC group as were concomitant thoracic injuries, such as pneumothorax and hemothorax. Sternal fractures without rib fractures were less common (3.8 %) than concomitant in the RF (10.1 %) and FC (14 %) groups, as were concomitant fractures of the clavicle and the scapula. Out of all patients 32.6 % showed fractures of the thoracolumbar spine, 26.5 % without rib fractures, 36.6-38.6 % with rib fractures or monolateral FC and 48.6 % concomitant to bilateral FC. Thoracotomy was carried

  5. Atomic bomb injury: radiation

    Energy Technology Data Exchange (ETDEWEB)

    Dunham, C L; Cronkite, E P; Le Roy, G V; Warren, S

    1959-01-01

    This document contains 3 reports. In the first report, the clinical diagnosis and treatment of radiation syndrome in survivors of the atomic explosions in Hiroshima and Nagasaki are described. The syndrome of acute radiation injury is applied to the symptom complex, or diseased state, which results from exposure of the whole body to the initial nuclear radiation of an atomic bomb. It is applied to injuries of the skin and subcutaneous tissues resulting from x-radiation or from contact with radioactive material. Internal radiation injury may result from the selective deposition, such as in bone or thyroid, of radioactive material that has been inhaled or absorbed through the gastrointestinal tract or wounds. Radiation syndrome is classified as very severe, severe, and mild. In the second report, a brief discussion is presented on the question of genetic effects in atomic bomb survivors in Hiroshima and Nagasaki. In the third report, a study was carried out on 205 4-1/2 year old children who had been exposed to the atomic bomb blast during the first half of intra-uterine life. Correlation between head size and mental development of the child with distance from the hypocenter, symptoms of radiation effect and type of shielding of the mother is discussed. The conclusion drawn from the present study is that central nervous system defects can be produced in the fetus by atomic bomb radiation, provided that exposure occurs within approximately 1200 meters of the hypocenter and that no effective shielding, such as concrete, protects the fetus from direct irradiation.

  6. Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review

    OpenAIRE

    Derakhshan, Adeeb; Lubelski, Daniel; Steinmetz, Michael P.; Corriveau, Mark; Lee, Sungho; Pace, Jonathan R.; Smith, Gabriel A.; Gokaslan, Ziya; Bydon, Mohamad; Arnold, Paul M.; Fehlings, Michael G.; Riew, K. Daniel; Mroz, Thomas E.

    2017-01-01

    Study Design: Multicenter retrospective case series. Objective: To determine the rate of thoracic duct injury during cervical spine operations. Methods: A retrospective case series study was conducted among 21 high-volume surgical centers to identify instances of thoracic duct injury during anterior cervical spine surgery. Staff at each center abstracted data for each identified case into case report forms. All case report forms were collected by the AOSpine North America Clinical Research Ne...

  7. Management of radiation injuries

    International Nuclear Information System (INIS)

    Roberto, Maria A.

    2003-01-01

    Injuries by exposure to ionizing radiation can be due to the detonation of a nuclear device in a military conflict, or it can occur following a large industrial accident (e.g. Chernobyl), or it can be the result of therapy (e.g. in a laboratory, in the case of cancer or other clinical situations). The severity of biological tissues damage depends on the energy deposited. The skin and subcutaneous tissue alone damaged may be related with an exposure to low energy radiation. In case of an exposure to high energy radiation the deeper structures will be involved. The treatment of the clinical situation after radiation requires special facilities (burn intensive care unit) and a massive support from a dedicated team. (author)

  8. Thoracic injury rule out criteria and NEXUS chest in predicting the risk of traumatic intra-thoracic injuries: A diagnostic accuracy study.

    Science.gov (United States)

    Safari, Saeed; Radfar, Fatemeh; Baratloo, Alireza

    2018-05-01

    This study aimed to compare the diagnostic accuracy of NEXUS chest and Thoracic Injury Rule out criteria (TIRC) models in predicting the risk of intra-thoracic injuries following blunt multiple trauma. In this diagnostic accuracy study, using the 2 mentioned models, blunt multiple trauma patients over the age of 15 years presenting to emergency department were screened regarding the presence of intra-thoracic injuries that are detectable via chest x-ray and screening performance characteristics of the models were compared. In this study, 3118 patients with the mean (SD) age of 37.4 (16.9) years were studied (57.4% male). Based on TIRC and NEXUS chest, respectively, 1340 (43%) and 1417 (45.4%) patients were deemed in need of radiography performance. Sensitivity, specificity, and positive and negative predictive values of TIRC were 98.95%, 62.70%, 21.19% and 99.83%. These values were 98.61%, 59.94%, 19.97% and 99.76%, for NEXUS chest, respectively. Accuracy of TIRC and NEXUS chest models were 66.04 (95% CI: 64.34-67.70) and 63.50 (95% CI: 61.78-65.19), respectively. TIRC and NEXUS chest models have proper and similar sensitivity in prediction of blunt traumatic intra-thoracic injuries that are detectable via chest x-ray. However, TIRC had a significantly higher specificity in this regard. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Helical CT of traumatic injuries of the thoracic aorta

    International Nuclear Information System (INIS)

    Mengozzi, E.; Burzi, M.; Miceli, M.; Lipparini, M.; Sartoni Galloni, S.

    2000-01-01

    Acute thoracic aortic injuries account for up to 10-20% of fatalities in high-speed deceleration road accidents and have an estimated immediate fatality rate of 80-90%. Untreated survivors to acute trauma (10-20%) have a dismal prognosis: 30% of them die within 6 hours, 40-50% die within 24 hours, and 90% within 4 months. It was investigated the diagnostic accuracy of Helical Computed Tomography (Helical CT) in acute traumatic injuries of the thoracic aorta, and the role of this technique in the diagnostic management of trauma patients with a strong suspicion of aortic rupture. It was compared retrospectively the chest Helical CT findings of 256 trauma patients examined June 1995 through August 1999. Chest Helical CT examinations were performed according to trauma score, to associated traumatic lesions and to plain chest radiographic findings. All the examinations were performed with no intravenous contrast agent administration and the pitch 2 technique. After a previous baseline study, contrast-enhanced scans were acquired with pitch 1 in 87 patients. Helical CT showed aortic lesions in 9 of 256 patients examined. In all the 9 cases it was found a mediastinal hematoma and all of them had positive plain chest radiographic findings of mediastinal enlargement. Moreover, in 6 cases aortic knob blurring was also evident on plain chest film and in 5 cases depressed left mainstem bronchus and trachea deviation rightwards were observed. All aortic lesions were identified on axial scans and located at the isthmus of level. Aortic rupture was always depicted as pseudo diverticulum of the proximal descending tract and intimal flap. It was also found that periaortic hematoma in 6 cases and intramural hematoma in 1 case. There were non false positive results in the series: 7 patients with Helical CT diagnosis of aortic rupture were submitted to conventional aortography that confirmed both type and extension of the lesions as detected by Helical CT, and all findings were

  10. Thoracic hyperextension injury with complete “bony disruption” of the thoracic cage: Case report of a potentially life-threatening injury

    Directory of Open Access Journals (Sweden)

    Bailey James

    2012-05-01

    Full Text Available Abstract Background Severe chest wall injuries are potentially life-threatening injuries which require a standardized multidisciplinary management strategy for prevention of posttraumatic complications and adverse outcome. Case presentation We report the successful management of a 55-year old man who sustained a complete “bony disruption” of the thoracic cage secondary to an “all-terrain vehicle” roll-over accident. The injury pattern consisted of a bilateral “flail chest” with serial segmental rib fractures, bilateral hemo-pneumothoraces and pulmonary contusions, bilateral midshaft clavicle fractures, a displaced transverse sternum fracture with significant diastasis, and an unstable T9 hyperextension injury. After initial life-saving procedures, the chest wall injuries were sequentially stabilized by surgical fixation of bilateral clavicle fractures, locked plating of the displaced sternal fracture, and a two-level anterior spine fixation of the T9 hyperextension injury. The patient had an excellent radiological and physiological outcome at 6 months post injury. Conclusion Severe chest wall trauma with a complete “bony disruption” of the thoracic cage represents a rare, but detrimental injury pattern. Multidisciplinary management with a staged timing for addressing each of the critical injuries, represents the ideal approach for an excellent long-term outcome.

  11. Initial assessment of chest X-ray in thoracic trauma patients: Awareness of specific injuries

    NARCIS (Netherlands)

    Aukema, Tjeerd S.; Beenen, Ludo F. M.; Hietbrink, Falco; Leenen, Luke Ph

    2012-01-01

    To compare the reported injuries on initial assessment of the chest X-ray (CXR) in thoracic trauma patients to a second read performed by a dedicated trauma radiologist. By retrospective analysis of a prospective database, 712 patients with an injury to the chest admitted to the University Medical

  12. A Rare Entity: Traumatic Thoracic Aortic Injury in a Patient with Aberrant Right Subclavian Artery.

    Science.gov (United States)

    Patel, Hiten Mohanbhai; Banerjee, Shubhabrata; Bulsara, Shahzad; Sahu, Tapish; Sheorain, Virender K; Grover, Tarun; Parakh, Rajiv

    2017-05-01

    Aberrant right subclavian artery is an uncommon entity incidence ranging from 0.5 to 2.5%. Management of thoracic aortic injury in the presence of such anomalies can be a challenge. We present here a case of traumatic aortic injury, which was incidentally found to have an asymptomatic aberrant right subclavian artery. The patient was managed by an endovascular repair of thoracic aortic injury with an endograft and a right carotid to subclavian artery bypass as a hybrid procedure. A 40-year male patient was brought to the emergency in shock with an alleged history of road traffic accident an hour back. After initial resuscitation as per advance trauma life support protocol, imaging revealed thoracic aortic injury with aberrant right subclavian artery with multiple rib and bilateral humerus fracture. After primary stabilization of arm fractures, the patient was shifted to a hybrid operation room. As the aortic injury was within 10 mm of the origin of both subclavian arteries, it was decided to cover the origin of both subclavian arteries and land the endograft distal to the left carotid artery origin. Since there was a right dominant vertebral artery on imaging, right carotid to right subclavian artery bypass was done with expanded polytetrafluoroethylene graft to prevent posterior circulatory stroke along with thoracic endovascular aortic repair to seal the thoracic aortic injury. After endovascular repair of thoracic aortic injury, left subclavian artery perfusion was maintained through left vertebral artery; and hence, revascularization of left subclavian artery was deferred. After management of all fractures, the patient was discharged 3 weeks after the date of admission without any complications. At 6 months follow-up, patient was stable and images showed patent bypass graft and sealed aortic injury. In a trauma setting with multiple injuries, hybrid procedure with a thoracic endograft is associated with low mortality and morbidity; hence, it is the treatment

  13. Lysosomes and radiation injury

    International Nuclear Information System (INIS)

    Watkins, D.K.

    1975-01-01

    Changes in activities of lysosomal enzymes following whole-body treatment with ionizing radiation have long been recognized (e.g., Douglass and Day 1955, Okada et al., 1957). Attempts to explain nuclear damage by cytoplasmic enzyme attack, concentrated most of the earlier work on DNASE II and acid RNASE. Lysosomal enzymes have subsequently been studied in many tissues following whole-body irradiation. The observations coupled with in vitro results from isolated lysosomes, and u.v. and visible light studies on cells in culture, have led to the presentation of tentative mechanisms of action. General methods of detecting lysosomal damage have utilized the consequent activation or leakage of acid hydrolases. As this is of a temporal nature following irradiation, direct damage to the lysosomal membrane has not as yet been measured and the primary lesion either in the membrane itself or at the hypothetical site of acid hydrolase-membrane attachment has still to be discovered. Despite the accumulating evidence of lysosome disruption subsequent to treatment with radiation of various qualities, the role (if any) of these organelles in cell killing remains obscure. In the following pages a review of the many aspects of radiation damage will be presented and an attempt will be made to correlate the results and to draw general conclusions where possible. A final short section will deal with thecontribution that lysosomal damage may make in cell death and tissue injury and possible implications in radiotherapy

  14. Profile of thoracic injury at College of Medical Sciences Teaching Hospital

    Directory of Open Access Journals (Sweden)

    D Chapagain

    2014-01-01

    Full Text Available Objectives: Thoracic injury is a challenge to the thoracic surgeon practicing in developing countries. This prospective study was conducted to see the mode of injury, injury types and overall outcome of thoracic injury in our settings. Materials and methods: This prospective study was conducted in 100 thoracic injury patients between December 2011 to June 2012. The demographic features, type of the trauma, radiological assessment, associated organ injuries, management of the injury, surgical interventions, morbidity, mortality, length of hospital stay were analysed. Results: In this study the ages ranged from 7 to 84 years. There were 73 (73% males and 27 (27% females. The majority of patients (83% were injured during the evening and night time. The majority of patients 92(92% sustained blunt chest injuries. The mechanism of injury was not significantly associated with length of hospital stay (P > 0.05 and mortality (P > 0.05.Road traffic accident was the most common cause of injuries affecting 68(68% of patients followed by fall injury of 19(19%. Rib fractures, haemothorax, pneumothorax and lung contusion were the most common type of injuries accounting for 83.0%, 57%,34% and 33% respectively. Associated extra-thoracic injuries were noted in 64.0% of patients. 45(45% of the cases of haemothorax, pneumotharax and haemopneumothorax were treated by tube thoracotomy. Four patients (04% had undergone thoracotomy. There were 09(09% patients of flail chest and treated conservatively. Fourty six patients (46% were admitted in the ICU. Eleven (11% patients were treated with ventilator support. Seventeen (17% patients had complication. The overall length of hospital stay ranged from 0 to 25 days. Conclusion: Road traffic accidents and fall from height are the major public health problems. Preventive measures at reducing road traffic accidents and timely management with closed tube thoracotomy are the main factors to be considered in the thoracic

  15. Changes in the Severity and Injury Sources of Thoracic Aorta Injuries due to Vehicular Crashes.

    Science.gov (United States)

    Ryb, Gabriel; Dischinger, Patricia; Kerns, Timothy; Burch, Cynthia; Rabin, Joseph; Ho, Shiu

    Research using the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) suggested a decreased adjusted risk of thoracic aorta injuries (TAI) for newer vehicles during near-side crashes and an increased adjusted TAI risk during frontal crashes. This study attempted to explore possible explanations of these findings. Adult front seat occupants in the Crash Injury Research and Engineering Network (CIREN) database through June 2012 were studied. TAI cases were compared with remaining cases in relation to crash and vehicular characteristics. TAI cases of later crash year (CY) (2004-2012) were compared to those in earlier CY (1996-2003) in relation to TAI severity (minor, moderate, severe and non-survivable). TAI cases in newer model year (MY) vehicles (1999-2012) were compared to those in older vehicles (1988-98) in relation to injury source (steering wheel, front, left, seat belt, air bag and other or unknown). Analysis was stratified by direction of impact (frontal and near-side) and the use of restraints. The similar TAI severity of earlier and later CY among frontal crashes suggests that the observed changes in the adjusted odds of injury seen in NASS-CDS are not due to an increase in injury detection. The decrease in TAI severity among newer vehicles in near-side crashes of later CY is consistent with a beneficial effect of crashworthiness improvements for this crash configuration. A shift of injury source in frontal crashes from the steering wheel in older vehicles to "front of vehicle structures", "seat belts" and "unknown and other" in newer vehicles should suggest potential sites for crashworthiness improvements.

  16. Identification of vehicle components associated with severe thoracic injury in motor vehicle crashes: a CIREN and NASS analysis.

    Science.gov (United States)

    Nirula, R; Pintar, F A

    2008-01-01

    Thoracic trauma secondary to motor vehicle crashes (MVC) continues to be a major cause of morbidity and mortality. Specific vehicle features may increase the risk of severe thoracic injury when striking the occupant. We sought to determine which vehicle contact points were associated with an increased risk of severe thoracic injury in MVC to focus subsequent design modifications necessary to reduce thoracic injury. The National Automotive Sampling System (NASS) databases from 1993 to 2001 and the Crash Injury Research and Engineering Network (CIREN) databases from 1996 to 2004 were analyzed separately using univariate and multivariate logistic regression stratified by restraint use and crash direction. The risk of driver thoracic injury, defined as an abbreviated injury scale (AIS) of score > or =3, was determined as it related to specific points of contact between the vehicle and the driver. The incidence of severe chest injury in NASS and CIREN were 5.5% and 33%, respectively. The steering wheel, door panel, armrest, and seat were identified as contact points associated with an increased risk of severe chest injury. The door panel and arm rest were consistently a frequent cause of severe injury in both the NASS and CIREN data. Several vehicle contact points, including the steering wheel, door panel, armrest and seat are associated with an increased risk of severe thoracic injury when striking the occupant. These elements need to be further investigated to determine which characteristics need to be manipulated in order to reduce thoracic trauma during a crash.

  17. Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review.

    Science.gov (United States)

    Derakhshan, Adeeb; Lubelski, Daniel; Steinmetz, Michael P; Corriveau, Mark; Lee, Sungho; Pace, Jonathan R; Smith, Gabriel A; Gokaslan, Ziya; Bydon, Mohamad; Arnold, Paul M; Fehlings, Michael G; Riew, K Daniel; Mroz, Thomas E

    2017-04-01

    Multicenter retrospective case series. To determine the rate of thoracic duct injury during cervical spine operations. A retrospective case series study was conducted among 21 high-volume surgical centers to identify instances of thoracic duct injury during anterior cervical spine surgery. Staff at each center abstracted data for each identified case into case report forms. All case report forms were collected by the AOSpine North America Clinical Research Network Methodological Core for data processing, cleaning, and analysis. Of a total of 9591 patients reviewed that underwent cervical spine surgery, 2 (0.02%) incurred iatrogenic injury to the thoracic duct. Both patients underwent a left-sided anterior cervical discectomy and fusion. The interruption of the thoracic duct was addressed intraoperatively in one patient with no residual postoperative effects. The second individual developed a chylous fluid collection approximately 2 months after the operation that required drainage via needle aspiration. Damage to the thoracic duct during cervical spine surgery is a relatively rare occurrence. Rapid identification of the disruption of this lymphatic vessel is critical to minimize deleterious effects of this complication.

  18. Prevention of ionizing radiation injuries

    International Nuclear Information System (INIS)

    Suzuki, Masashi

    1976-01-01

    In the first age (1895 - 1940), radiation injuries of skin (75% of death caused by RI injury) and chronic radiation injury of heamatopoietic organs (almost remains) appeared in radiologist and people engaged in RI treatment for medical use, and Ra poisoning appeared in workers who treated aluminous paint. As prevention of radiation injuries in this age, measurement of radiation dose, shelter effect and finding of injuries were studied, and internal radiation allowed level was determined. From 1942 to 1960, acute RI injuries due to exposure of large amount of RI by an accident and secondary leukemia appeared to workers of atomic-bomb industries and researcher of atomic energy. U and Pu poisoning accompanied with development of nuclear fuel industry appeared. This expanded industrial hygiene of this age together with epidemiological data of atomic-bomb exposed people. From 1960 onward, it is an age of industry for peaceful use of atomic energy, and manifestation of various kinds of delayed injuries, especially malignant tumor due to RI exposure, is recognized. Labourer has many opportunity to encounter dangerously with pollution and injuries by RI, and regional examination of RI enterprise and countermeasure to decrease exposure dose were mentioned as future theme from a viewpoint of exposure dose of nation. (Kanao, N.)

  19. Treatment Results of Injuries of Thoracic and Lumbar Backbone Departments at Osteoporosis Patients

    Directory of Open Access Journals (Sweden)

    D.Y. Sumin

    2009-06-01

    Full Text Available Information relates to radiologic (computer tomography manifestations providing the visualization of thoracic and lumbar backbone department injuries at osteoporotic patients. Contemporary methods of transcutaneous and trans-pedicle vertebroplasty with bone cement allows to obtain a stable positive healing effect against such pathologies.

  20. A conservative approach to a thoracic duct injury caused by left subclavian vein catheterization

    OpenAIRE

    Vedran Premuzic; Ranko Smiljanic; Drazen Perkov

    2018-01-01

    Thoracic duct injury is a rare complication of left subclavian vein catheterization. A significant injury could lead to chylothorax, a condition with high mortality rate if not treated. It is diagnosed with lymphography or by laboratory tests of pleural fluid aspirate. A 51 year old Caucasian male with a history of unregulated hypertension presented to our Emergency department (ED) with anginous symptoms and increased serum creatinine level. After the placement of a temporary central venous c...

  1. Long descending cervical propriospinal neurons differ from thoracic propriospinal neurons in response to low thoracic spinal injury

    Directory of Open Access Journals (Sweden)

    Stelzner Dennis J

    2010-11-01

    Full Text Available Abstract Background Propriospinal neurons, with axonal projections intrinsic to the spinal cord, have shown a greater regenerative response than supraspinal neurons after axotomy due to spinal cord injury (SCI. Our previous work focused on the response of axotomized short thoracic propriospinal (TPS neurons following a low thoracic SCI (T9 spinal transection or moderate spinal contusion injury in the rat. The present investigation analyzes the intrinsic response of cervical propriospinal neurons having long descending axons which project into the lumbosacral enlargement, long descending propriospinal tract (LDPT axons. These neurons also were axotomized by T9 spinal injury in the same animals used in our previous study. Results Utilizing laser microdissection (LMD, qRT-PCR, and immunohistochemistry, we studied LDPT neurons (located in the C5-C6 spinal segments between 3-days, and 1-month following a low thoracic (T9 spinal cord injury. We examined the response of 89 genes related to growth factors, cell surface receptors, apoptosis, axonal regeneration, and neuroprotection/cell survival. We found a strong and significant down-regulation of ~25% of the genes analyzed early after injury (3-days post-injury with a sustained down-regulation in most instances. In the few genes that were up-regulated (Actb, Atf3, Frs2, Hspb1, Nrap, Stat1 post-axotomy, the expression for all but one was down-regulated by 2-weeks post-injury. We also compared the uninjured TPS control neurons to the uninjured LDPT neurons used in this experiment for phenotypic differences between these two subpopulations of propriospinal neurons. We found significant differences in expression in 37 of the 84 genes examined between these two subpopulations of propriospinal neurons with LDPT neurons exhibiting a significantly higher base line expression for all but 3 of these genes compared to TPS neurons. Conclusions Taken collectively these data indicate a broad overall down

  2. "Thunderstruck": penetrating thoracic injury from lightning strike.

    Science.gov (United States)

    van Waes, Oscar J F; van de Woestijne, Pieter C; Halm, Jens A

    2014-04-01

    Lightning strike victims are rarely presented at an emergency department. Burns are often the primary focus. This case report describes the improvised explosive device like-injury to the thorax due to lightning strike and its treatment, which has not been described prior in (kerauno)medicine. Penetrating injury due to blast from lightning strike is extremely rare. These "shrapnel" injuries should however be ruled out in all patients struck by lightning. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  3. Trunk muscle activation in a person with clinically complete thoracic spinal cord injury.

    Science.gov (United States)

    Bjerkefors, Anna; Carpenter, Mark G; Cresswell, Andrew G; Thorstensson, Alf

    2009-04-01

    The aim of this study was to assess if, and how, upper body muscles are activated in a person with high thoracic spinal cord injury, clinically classified as complete, during maximal voluntary contractions and in response to balance perturbations. Data from one person with spinal cord injury (T3 level) and one able-bodied person were recorded with electromyography from 4 abdominal muscles using indwelling fine-wire electrodes and from erector spinae and 3 upper trunk muscles with surface electrodes. Balance perturbations were carried out as forward or backward support surface translations. The person with spinal cord injury was able to activate all trunk muscles, even those below the injury level, both in voluntary efforts and in reaction to balance perturbations. Trunk movements were qualitatively similar in both participants, but the pattern and timing of muscle responses differed: upper trunk muscle involvement and occurrence of co-activation of ventral and dorsal muscles were more frequent in the person with spinal cord injury. These findings prompt further investigation into trunk muscle function in paraplegics, and highlight the importance of including motor tests for trunk muscles in persons with thoracic spinal cord injury, in relation to injury classification, prognosis and rehabilitation.

  4. Multidimensional Analysis of Magnetic Resonance Imaging Predicts Early Impairment in Thoracic and Thoracolumbar Spinal Cord Injury

    Science.gov (United States)

    Mabray, Marc C.; Whetstone, William D.; Dhall, Sanjay S.; Phillips, David B.; Pan, Jonathan Z.; Manley, Geoffrey T.; Bresnahan, Jacqueline C.; Beattie, Michael S.; Haefeli, Jenny

    2016-01-01

    Abstract Literature examining magnetic resonance imaging (MRI) in acute spinal cord injury (SCI) has focused on cervical SCI. Reproducible systems have been developed for MRI-based grading; however, it is unclear how they apply to thoracic SCI. Our hypothesis is that MRI measures will group as coherent multivariate principal component (PC) ensembles, and that distinct PCs and individual variables will show discriminant validity for predicting early impairment in thoracic SCI. We undertook a retrospective cohort study of 25 patients with acute thoracic SCI who underwent MRI on admission and had American Spinal Injury Association Impairment Scale (AIS) assessment at hospital discharge. Imaging variables of axial grade, sagittal grade, length of injury, thoracolumbar injury classification system (TLICS), maximum canal compromise (MCC), and maximum spinal cord compression (MSCC) were collected. We performed an analytical workflow to detect multivariate PC patterns followed by explicit hypothesis testing to predict AIS at discharge. All imaging variables loaded positively on PC1 (64.3% of variance), which was highly related to AIS at discharge. MCC, MSCC, and TLICS also loaded positively on PC2 (22.7% of variance), while variables concerning cord signal abnormality loaded negatively on PC2. PC2 was highly related to the patient undergoing surgical decompression. Variables of signal abnormality were all negatively correlated with AIS at discharge with the highest level of correlation for axial grade as assessed with the Brain and Spinal Injury Center (BASIC) score. A multiple variable model identified BASIC as the only statistically significant predictor of AIS at discharge, signifying that BASIC best captured the variance in AIS within our study population. Our study provides evidence of convergent validity, construct validity, and clinical predictive validity for the sampled MRI measures of SCI when applied in acute thoracic and thoracolumbar SCI. PMID:26414451

  5. Penetrating abdomino-thoracic injury with an iron rod: An anaesthetic challenge

    Directory of Open Access Journals (Sweden)

    Kiranpreet Kaur

    2014-01-01

    Full Text Available Penetrating abdomino-thoracic injuries are potentially life-threatening due to the associated haemorrhagic shock and visceral injury. The management of these injuries poses specific challenges in pre-hospital care, transport, and management strategies. We report a 35-year-old male having impalement injury of the left thorax and left upper arm with a metallic rod used for construction of the house after a fall from height. One rod penetrated thorax from left shoulder and exit point was present just above the iliac crest and second rod was seen piercing left upper arm. Patient was successfully managed without any intraoperative, post-operative surgical complications, neurological damage or permanent injuries.

  6. Frequency and significance of thoracic injuries detected on abdominal trauma CT scans

    International Nuclear Information System (INIS)

    Hareli, G.S.; Rhea, J.T.; Novelline, R.A.; Lawrason, N.; Sacknoff, R.; Oser, A.

    1987-01-01

    The authors have noted that in multiple trauma patients chest injuries inapparent on initial chest radiographs may be detected at abdominal CT. In an ongoing series of 112 patients to date, 50 chest injuries were detected in 33 patients (29%). The injuries included 15 bilateral hemothoraces, seven unilateral hemothoraces, seven posttraumatic atrelectasis, seven lung contusions, five pneumothoraces, four rib factures, two thoracic spine fractures, two chest wall emphysema, and one mediastinal emphysema. In 24 of the 33 patients (72%) the injury was not seen on the initial chest radiographs; in seven patients treatment of the chest injury was required. The authors have included screening cuts of the middle and upper chest as part of their abdominal CT protocol

  7. Imaging of Combat-Related Thoracic Trauma - Blunt Trauma and Blast Lung Injury.

    Science.gov (United States)

    Lichtenberger, John P; Kim, Andrew M; Fisher, Dane; Tatum, Peter S; Neubauer, Brian; Peterson, P Gabriel; Carter, Brett W

    2018-03-01

    Combat-related thoracic trauma (CRTT) is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries are the most common mechanisms of trauma to the chest. Imaging plays a key role in the battlefield management of CRTT casualties. This work discusses the imaging manifestations of thoracic injuries from blunt trauma and blast injury, emphasizing epidemiology and diagnostic clues seen during OEF and OIF. The assessment of radiologic findings in patients who suffer from combat-related blunt thoracic trauma and blast injury is the basis of this work. The imaging modalities for this work include multi-detector computed tomography (MDCT) and chest radiography. Multiple imaging modalities are available to imagers on or near the battlefront, including radiography, fluoroscopy, and MDCT. MDCT with multi-planar reconstructions is the most sensitive imaging modality available in combat hospitals for the evaluation of CRTT. In modern combat, blunt and blast injuries account for a significant portion of CRTT. Individual body armor converts penetrating trauma to blunt trauma, leading to pulmonary contusion that accounted for 50.2% of thoracic injuries during OIF and OEF. Flail chest, a subset of blunt chest injury, is caused by significant blunt force to the chest and occurs four times as frequently in combat casualties when compared with the civilian population. Imaging features of CRTT have significant diagnostic and prognostic value. Pulmonary contusions on chest radiography appear as patchy consolidations in the acute setting with ill-defined and non-segmental borders. MDCT of the chest is a superior imaging modality in diagnosing and evaluating pulmonary contusion. Contusions on MDCT appear as crescentic ground-glass opacities (opacities through which lung interstitium and vasculature are still visible) and areas of consolidation that often do not

  8. Radiation-induced heart injury

    International Nuclear Information System (INIS)

    Suzuki, Yoshihiko; Niibe, Hideo

    1975-01-01

    In order to identify radiation-induced heart injury and to differentiate it from heart disease, an attempt was made to clarify post-irradiation heart injury by investigating the histological changes which occur during the internal between the irradiation and the time of demonstrable histological changes. A study was made of 83 autopsies in which most of the primary neoplasms were breast cancers, lung cancers and mediastinal tumors. In 43 of these autopsies the heart had been irradiated. Sixty eight dd-strain mice were also used for microautoradiographic study. Histological changes in the heart were observed in 27 of the 43 cases receiving irradiation. The limit of the tolerance dose to the heart for indicating histological changes was 1220 ret in humans. The latent period without histological changes was 2.7 months after initiation of radiation therapy. Greater heart injury was observed after re-irradiation or after the combined therapy of radiation and chemotherapy especially mitomycin (MMC). The histological findings after treatment with MMC were similar to those of radiation-induced heart injury. Results of the study indicate that the damage is secondary to radiation-induced changes of the vascula connective tissue. (Evans, G.)

  9. Possible radiation induced cancer of the thoracic esophagus after postoperative irradiation for the breast cancer

    International Nuclear Information System (INIS)

    Ueda, Mamoru; Matsubara, Toshiki; Kasumi, Fujio; Nishi, Mitsumasa; Kajitani, Tamaki

    1991-01-01

    We report 11 patients with cancer of the thoracic esophagus developing after postoperative irradiation therapy for breast cancer. Irradiation was done immediately after mastectomy in these patients and the irradiation field included the unilateral or bilateral parasternal region. They received a total dose ranging from 35 Gy to 60 Gy and the dose received to the thoracic esophagus was estimated from 10 Gy to 48 Gy. All cancer sites were involved in the irradiation field. The latent intervals of 10 patients from radiation to the manifest of cancer ranged from 10 to 19 years. Among 4777 women undergoing mastectomy for breast cancer between 1946 and 1980 in our hospital, 8 women (0.17%) developed cancer of the thoracic esophagus, whereas 5 (0.335%) out of 1534 women treated with mastectomy and radiotherapy with Linac between 1964 and 1980 developed cancer of the thoracic esophagus. Higher incidence of esophageal cancer in patients treated with surgery and radiation suggests that these cancers might be induced by radiation. Eight patients had esophagectomy and 4 patients of them received postoperative irradiation. They have survived from 9 months to 13 years. Two patients were controlled well by the irradiation alone. It is interesting that radiation therapy is sensitive to the possible radiation induced cancer of the thoracic esophagus. Follow up study should be directed to the possible development of second malignancy in patients who survive for a long time after radiation therapy. (author)

  10. Radiation injuries and recovery

    International Nuclear Information System (INIS)

    Pauly, H.

    1974-01-01

    In memory of Prof. Dr. Langendorff, a survey and a cross-section are given of the development of radiobiology during the last 40 years. The importance of radiobiology is shown using several examples. The mechanisms and effects of radiation on man, animals and plants are discussed. Effects of radiation and radiolesious are explained down ot the molecular field, and their importance is discussed quantitatively with stochastic considerations. Stress is laid upon recovering from radiolesious. It is tried to explain recovery quantitatively in all its several sorts. Using all these deliberations, the author also tries to give a wide spectrum for radiation protection. These fundamental deliberations and works of Prof. Dr. Langendorff are guidelines of great importance also for radiation protection in connection with the protection of the civil population. (GSE) [de

  11. Imaging of acute traumatic injuries of the thoracic aorta

    International Nuclear Information System (INIS)

    Wintermark, Max; Wicky, Stefan; Schnyder, Pierre

    2002-01-01

    Blunt traumatic aortic injuries are a major concern in the settings of high-speed deceleration accidents, since they are associated with a very high mortality rate; however, with prompt diagnosis and surgery, 70% of the patients with a blunt aortic lesion who reach the hospital alive will survive. This statement challenges the emergency radiologist in charge to evaluate the admission radiological survey in a severe chest trauma patient. With a 95% negative predictive value for the identification of blunt traumatic aortic lesions, plain chest film represents an adequate screening test. If aortography remains the gold standard, it tends, at least in hemodynamically stable trauma patients, to be replaced by spiral-CT angiography (SCTA), which demonstrates a 96.2% sensitivity, a 99.8% specificity, and a 99.7% accuracy. In unstable patients, trans-esophageal echography (TEE) plays a major diagnostic role. Knowledge of advantages and pitfalls of these imaging techniques, as reviewed in this article, will help the emergency radiologist to choose the appropriate algorithm in the diagnosis of traumatic aortic injury, for each trauma patient. (orig.)

  12. Lumbar Myeloid Cell Trafficking into Locomotor Networks after Thoracic Spinal Cord Injury

    Science.gov (United States)

    Hansen, Christopher N.; Norden, Diana M.; Faw, Timothy D.; Deibert, Rochelle; S.Wohleb, Eric; Sheridan, John F.; P.Godbout, Jonathan; Basso, D. Michele

    2016-01-01

    Spinal cord injury (SCI) promotes inflammation along the neuroaxis that jeopardizes plasticity, intrinsic repair and recovery. While inflammation at the injury site is well-established, less is known within remote spinal networks. The presence of bone marrow-derived immune (myeloid) cells in these areas may further impede functional recovery. Previously, high levels of the gelatinase, matrix metalloproteinase-9 (MMP-9) occurred within the lumbar enlargement after thoracic SCI and impeded activity-dependent recovery. Since SCI-induced MMP-9 potentially increases vascular permeability, myeloid cell infiltration may drive inflammatory toxicity in locomotor networks. Therefore, we examined neurovascular reactivity and myeloid cell infiltration in the lumbar cord after thoracic SCI. We show evidence of region-specific recruitment of myeloid cells into the lumbar but not cervical region. Myeloid infiltration occurred with concomitant increases in chemoattractants (CCL2) and cell adhesion molecules (ICAM-1) around lumbar vasculature 24 hours and 7 days post injury. Bone marrow GFP chimeric mice established robust infiltration of bone marrow-derived myeloid cells into the lumbar gray matter 24 hours after SCI. This cell infiltration occurred when the blood-spinal cord barrier was intact, suggesting active recruitment across the endothelium. Myeloid cells persisted as ramified macrophages at 7 days post injury in parallel with increased inhibitory GAD67 labeling. Importantly, macrophage infiltration required MMP-9. PMID:27191729

  13. A clinical case study of long-term injury of the thoracic and lumbar spine

    Directory of Open Access Journals (Sweden)

    Vladimir V Zaretskov

    2016-06-01

    Full Text Available Overestimation of the efficacy of conservative treatment of spine injuries children often leads to unsatisfactory long-term results. The effective correction of post-traumatic spinal column deformities occurs in patients who undergo the operation in the early post-traumatic period. While choosing treatment strategies for children, higher reparative opportunities, which provide early fracture consolidation, including those in faulty positions, should be considered. This study presents a case of surgical treatment for uncomplicated injury of the thoracic and lumbar spine, with long-term compression fragmental fracture of the L1 vertebra body in a 12-year-old child. Due to the long-standing character of the injury right thoraco-frenotomy was conducted with partial L1 vertebral body and resection of the adjacent discs, deformity correction of the thoracic and lumbar spine with a transpedicular system, and ventral spondylodesis with an autograft. This extensive intervention was justified by the peculiarities in the vertebral body damage and the post-traumatic segmental kyphotic deformity that resulted from delayed medical treatment. An anterior approach was chosen to achieve immobilization at the site of the damage before correction using the transpedicular system. Surgical correction of long-term spinal injuries in children, with the use of a combined approach, is usually laborious and traumatic. The prevention of rigid post-traumatic spine deformities with the help of timely diagnostics and appropriate treatment, including surgery, should be a priority to prevent such cases.

  14. Radiologic observations on pulmonary radiation injury

    International Nuclear Information System (INIS)

    Liang Yong

    1992-01-01

    Based on the data of pulmonary radiation injury in 16 cases, the relationship among the radiation dosage and field, the development and onset time of the pulmonary radiation injury were discussed, and the dynamic changes of pulmonary radiation injury in X-ray films were analysed. The author found that: (1) there was a close relationship between the development of radiation injury and radiation dosages and the size of radiation fields, i.e. for the large radiation field, a relatively small dosage was needed for developing radiation injury ; (2) most off acute radiation injury of the lungs appeared within one month of postirradiation therapy, and the chronic pulmonary fibrosis appeared at 4.23 months after radiation therapy, with a fibrosis rate of about 85.7% within a half year; (3) the clinical manifestations of pulmonary radiation injury were not parallel to the X-ray signs, namely the X-ray changes were more severe than clinical manifestations. On the basis of X-ray signs and the dynamic changes of pulmonary radiation injury, the differentiation of radiation injury from interstitial pulmonary metastasis, primary tumor, common pneumonia, and tumor recurrence after radiation therapy were discussed

  15. A case of a traumatic chyle leak following an acute thoracic spine injury: successful resolution with strict dietary manipulation

    Directory of Open Access Journals (Sweden)

    Skinner Ruby A

    2011-03-01

    Full Text Available Abstract Background Chylothorax is a rare form of pleural effusion that can be associated with both traumatic and non-traumatic causes. Thoracic duct ligation is often the treatment of choice in postsurgical patients; however the optimal treatment of this disease process after traumatic injury remains unclear 1. We present a rare case of a thoracic duct injury secondary to a blunt thoracic spine fracture and subluxation which was successfully treated non-operatively. Case Presentation A 51 year old male presented as a tier one trauma code due to an automobile versus bicycle collision. His examination and radiographic work-up revealed fractures and a subluxation at the third and fourth thoracic spine levels resulting in paraplegia. He also sustained bilateral hemothoraces secondary to multiple rib fractures. Drainage of the left hemothorax led to the diagnosis of a traumatic chylothorax. The thoracic spine fractures were addressed with surgical stabilization and the chylothorax was successfully treated with drainage and dietary manipulation. Conclusions This unusual and complex blunt thoracic duct injury required a multidisciplinary approach. Although the spine injury required surgical fixation, successful resolution of the chyle leak was achieved without surgical intervention.

  16. Carnosine may reduce lung injury caused by radiation therapy.

    Science.gov (United States)

    Guney, Yildiz; Turkcu, Ummuhani Ozel; Hicsonmez, Ayse; Andrieu, Meltem Nalca; Guney, H Zafer; Bilgihan, Ayse; Kurtman, Cengiz

    2006-01-01

    Ionising radiation is known one of the most effective tools in the therapy of cancer but in many thoracic cancers, the total prescribed dose of radiation that can be safely administered to the target volume is limited by the risk of complications arising in the normal lung tissue. One of the major reasons for cellular injury after radiation is the formation of reactive oxygen species (ROS). Radiation pneumonitis is an acute phase side-effect which generally subsides after a few weeks and is followed by a chronic phase characterized by inflammation and fibrosis, that can develop months or years after irradiation. Carnosine is a dipeptide composed by the amino acids beta-histidine and l-alanine. The exact biological role of carnosine is not totally understood, but several studies have demonstrated that it possesses strong and specific antioxidant properties, protects against radiation damage,and promotes wound healing. The antioxidant mechanism of carnosine is attributed to its chelating effect against metal ions, superoxide dismutase (SOD)-like activity, ROS and free radicals scavenging ability . Either its antioxidant or anti-inflammatuar properties, we propose that carnosine ameliorates irradiation-induced lung injury. Thus, supplementing cancer patients to whom applied radiation therapy with carnosine, may provide an alleviation of the symptoms due to radiation-induced lung injury. This issue warrants further studies.

  17. Cell membranes in radiation injury

    International Nuclear Information System (INIS)

    Koeteles, G.J.

    1986-01-01

    Cell membrane-related phenomena caused by low linear energy transfer radiation with doses lower than those producing cell killing are outlined. Micromorphological alterations as well as functional activities appearing with the receptors and in binding sites render it possible to reveal early and temporary changes. The cell injuries are suggested to transfer damaging conditions to surviving cells and to contribute to further development of non-stochastic effects in tissues

  18. Morphological aspects of radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Congdon, C C; Fliedner, T M

    1971-04-01

    The injury to haemopoietic and lymphatic tissues produced by ionizing irradiation in various species of mammals including man is one of the major features of the biological effects of radiation (Bond et al. 1965,' Cottier, 1961). At the moment of injury and for a short time thereafter relatively little morphological evidence of cell damage in bone marrow other than cessation of cell division and DNA synthesis is seen. Within a few hours, however, depending on the level of exposure, major destruction of red bone marrow tissue can occur. In this chapter the histologic changes in bone marrow are summarized for correlation with the functional aspects of the change in the target tissue, particularly its cell renewal features and where possible the remarkable flux or migration of cells through bone marrow and lymphatic tissues. This latter topic of cellular traffic represents the outcome of extensive physiological studies on haemopoiesis and lymphopoiesis by mammalian radiobiologists. The initial injury, the structural changes and the physiological consequences are the first half of the radiation injury sequence. Regeneration also has morphological features of major importance to the understanding of radiation haematology. It is common to discuss radiation effects on biological materials from the point of view of external or internal sources of exposure. In addition exposure rate, whole body or partial body, type and quality of the ionizing source are features that must be taken into account. While these features are extremely important, the simplest approach to understanding histologic effects on the bone marrow is to assume acute penetrating whole-body exposure in the lethal range. With this background the differences related to variations in the conditions of exposure can usually be understood. The individual human or animal organism receiving the exposure must also be considered in the final outcome of the experience because age, sex, nutritional status and presence

  19. Thoracic Trauma.

    Science.gov (United States)

    Dennis, Bradley M; Bellister, Seth A; Guillamondegui, Oscar D

    2017-10-01

    Management of chest trauma is integral to patient outcomes owing to the vital structures held within the thoracic cavity. Understanding traumatic chest injuries and appropriate management plays a pivotal role in the overall well-being of both blunt and penetrating trauma patients. Whether the injury includes rib fractures, associated pulmonary injuries, or tracheobronchial tree injuries, every facet of management may impact the short- and long-term outcomes, including mortality. This article elucidates the workup and management of the thoracic cage, pulmonary and tracheobronchial injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. DIFFERENT TYPES OF INSPIRATORY MUSCLE TRAINING PROVIDES BETTERMENT IN ALTERED PULMONARY FUNCTIONS IN UPPER THORACIC SPINAL CORD INJURIES

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    Muruganandam Periyasamy

    2016-08-01

    Full Text Available Background: Respiratory problems are usual in upper thoracic spinal cord injuries when compared to Lower thoracic spinal cord injuries. Generally there are frequent respiratory complications in the individuals with spinal cord injuries. The complications of the respiratory system are severe and more prevalent source of morbidity and mortality after the spinal cord injury due to the inefficient breathing capacity including inspiratory and expiratory abilities. The present study represents the inspiratory muscle training especially in upper thoracic spinal cord injury patients to assess the improvement in the pulmonary functions. Methods: Twenty five patients with the age between 25 -40 years with the upper spinal cord injuries were selected in the present study in order to assess the efficacy of the training. Several types of exercises were practiced including diaphragmatic breathing exercises, incentive spirometry, active cycle of breathing technique and weight training. COPD Conditions, Chest wall deformities, Hypertensive patients, Cardio vascular problems were excluded in the study. Results: The results from the study showed that significant changes were found in the patients treated with all the above mentioned techniques. Axillary level, nipple level, Xiphisternum levels were analysed and the results found to be significant after the treatment. Incentive spirometry and peak flow meter observations were also found to be significant when compare to the pretreatment. Conclusion: The present study conclude that the combined effect of incentive spriometry, diaphragmatic breathing exercises, and active cycle of breathing technique is more effective in improving the pulmonary functions in upper thoracic spinal cord injuries than single method efficiency.

  1. Prognosis of phrenic nerve injury following thoracic interventions: four new cases and a review.

    Science.gov (United States)

    Ostrowska, Monika; de Carvalho, Mamede

    2012-04-01

    Phrenic nerve lesion is a known complication of thoracic surgical intervention, but it is rarely described following thymectomy and lung surgery. To review the literature on thoracic intervention and phrenic nerve lesion and to describe four new cases, in which regular neurophysiological studies were performed. We reviewed the literature concerning phrenic nerve lesion after cardiac, lung and thymus surgical interventions. We described four cases of phrenic nerve lesion, three associated with thymectomy and one in lung surgery. The review shows that cryogenic or thermal injuries during cardiac surgeries are associated with good prognosis. The information on the outcome of phrenic nerve lesion in thymectomy or lung surgery is insufficient. Our cases and this review suggest that phrenic lesion in the last two interventions are associated with a poor recovery. Our data suggests that the prognosis of phrenic nerve lesion following thoracic intervention depends on the nature of the damage. Probably, in thymectomy and lung surgery, nerve stretch or laceration are involved, consequently the outcome is poorer in comparison with cardiac surgery, where cold lesion is more frequent. Neurophysiological tests give a direct, quantified and reliable assessment of nerve regeneration. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. Double Level Extension-Distraction Thoracic Spine Injuries with Concomitant Double Level Sternal Fractures: A Case Report

    Directory of Open Access Journals (Sweden)

    CK Lee

    2011-03-01

    Full Text Available Extension-distraction injury of the spine is rare. A majority of these cases occur in the cervical region and at an isolated level. Rare instances of this injury have been described in an ankylosed or fused spine. This case report describes a rare two level extension-distraction thoracic spine injury in an otherwise healthy adult resulting from a motor vehicle accident.

  3. Expression of Angiotensin II and Aldosterone in Radiation-induced Lung Injury

    OpenAIRE

    Cao, Shuo; Wu, Rong

    2012-01-01

    Objective Radiation-induced lung injury (RILI) is the most common, dose-limiting complication in thoracic malignancy radiotherapy. Considering its negative impact on patients and restrictions to efficacy, the mechanism of RILI was studied. Methods Wistar rats were locally irradiated with a single dose of 0, 16, and 20 Gy to the right half of the lung to establish a lung injury model. Two and six months after irradiation, the right half of the rat lung tissue was removed, and the concentration...

  4. A conservative approach to a thoracic duct injury caused by left subclavian vein catheterization

    Directory of Open Access Journals (Sweden)

    Vedran Premuzic

    2018-01-01

    Full Text Available Thoracic duct injury is a rare complication of left subclavian vein catheterization. A significant injury could lead to chylothorax, a condition with high mortality rate if not treated. It is diagnosed with lymphography or by laboratory tests of pleural fluid aspirate. A 51 year old Caucasian male with a history of unregulated hypertension presented to our Emergency department (ED with anginous symptoms and increased serum creatinine level. After the placement of a temporary central venous catheter for hemodialysis in left subclavian vein, he developed lymph leakage on puncture site beside the catheter, at drainage rate of 75 ml/h. In the absence of more serious clinical symptoms, conservative treatment with close patient monitoring and diet changes was chosen, rather than more invasive treatment options.

  5. Radiation therapy for the cervical and upper thoracic esophageal cancer

    International Nuclear Information System (INIS)

    Chatani, Masashi; Teshima, Teruki; Inoue, Toshihiko

    1990-01-01

    This is a retrospective analysis of 19 patients with carcinoma of the cervical esophagus (Ce) and 36 of the upper thoracic esophagus (Iu) treated with radiotherapy between September 1977 and December 1987. Three-year survival rates by Kaplan-Meier method were 18% in Ce cancer and 7% in Iu cancer. Two-year local tumor control was obtained in 3 Ce and 4 Iu cancer. Concerning the treatment methods for the above 7 patients, 3 patients with carcinoma of the Ce were treated with double wedged technique and 4 of Iu were treated with box-technique (2 patients), rotation technique (1) and double wedge technique (1). There were no 2-year local tumor control in patients who received less than 60 Gy of the tumor dose or whose tumor exceeded more than 10 cm in length. Double wedge technique is suitable for radiotherapy of Ce cancer, while further investigation of dose and compensation is necessary for Iu cancer. (author)

  6. Neural progenitor cells but not astrocytes respond distally to thoracic spinal cord injury in rat models

    Directory of Open Access Journals (Sweden)

    Tara Nguyen

    2017-01-01

    Full Text Available Traumatic spinal cord injury (SCI is a detrimental condition that causes loss of sensory and motor function in an individual. Many complex secondary injury cascades occur after SCI and they offer great potential for therapeutic targeting. In this study, we investigated the response of endogenous neural progenitor cells, astrocytes, and microglia to a localized thoracic SCI throughout the neuroaxis. Twenty-five adult female Sprague-Dawley rats underwent mild-contusion thoracic SCI (n = 9, sham surgery (n = 8, or no surgery (n = 8. Spinal cord and brain tissues were fixed and cut at six regions of the neuroaxis. Immunohistochemistry showed increased reactivity of neural progenitor cell marker nestin in the central canal at all levels of the spinal cord. Increased reactivity of astrocyte-specific marker glial fibrillary acidic protein was found only at the lesion epicenter. The number of activated microglia was significantly increased at the lesion site, and activated microglia extended to the lumbar enlargement. Phagocytic microglia and macrophages were significantly increased only at the lesion site. There were no changes in nestin, glial fibrillary acidic protein, microglia and macrophage response in the third ventricle of rats subjected to mild-contusion thoracic SCI compared to the sham surgery or no surgery. These findings indicate that neural progenitor cells, astrocytes and microglia respond differently to a localized SCI, presumably due to differences in inflammatory signaling. These different cellular responses may have implications in the way that neural progenitor cells can be manipulated for neuroregeneration after SCI. This needs to be further investigated.

  7. Radiation injury to the nervous system

    International Nuclear Information System (INIS)

    Gutin, P.H.; Leibel, S.A.; Sneline, G.E.

    1991-01-01

    This book is designed to describe to the radiation biologist, radiation oncologist, neurologist, neurosurgeon, medical oncologist, and neuro-oncologist, the current state of knowledge about the tolerance of the nervous system to various kinds of radiation, the mechanisms of radiation injury, and how nervous system tolerance and injury are related to the more general problem of radiation damage to normal tissue of all types. The information collected here should stimulate interest in and facilitate the growing research effort into radiation injury to the nervous system

  8. Differential diagnosis of radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Wendt, F

    1971-04-01

    A single haematological alteration is not sufficient to diagnose whether it is a radiation-induced change or not. For the differential diagnosis of possibly radiation-induced changes in the peripheral blood and blood-forming organs, information on the radiation exposure in terms of time, quality, quantity and localization, and the clinical symptoms have to be taken into account. Ionizing radiation within the dosage range considered here produces cell division delay, mitotic inhibition, chromosomal damage or interphase cell death; it thereby interferes with the steady-state equilibria in the cell-renewal systems of the organism (Bond et al., 1965; Little, 1968). The cause of haematological changes appearing immediately after a short-term, external whole-body radiation exposure has been described and analysed elsewhere in this Manual. The critical cell component is the 'stem cell compartment' which is highly radiosensitive and suffers damage but, because stem cells cannot be identified morphologically, a direct study of stem cell injury is not possible.

  9. Mid-Thoracic Spinal Injuries during Horse Racing: Report of 3 Cases and Review of Causative Factors and Prevention Measurements

    OpenAIRE

    Triantafyllopoulos, Ioannis; Panagopoulos, Andreas; Sapkas, George

    2013-01-01

    We report three cases of a rare pattern of mid-thoracic spine injuries after horse racing falls and discuss possible causative factors and prevention measurements to reduce injury rates in professional riding and racing. Three patients, 2 male and 1 female with a mean age of 28 years old, underwent surgical treatment for mid-thoracic fractures after professional equestrian activities. The ASIA scale was E in one patient, B in the other one and A in the third. Multilevel posterior fusion was u...

  10. Role of volume rendered 3-D computed tomography in conservative management of trauma-related thoracic injuries.

    LENUS (Irish Health Repository)

    OʼLeary, Donal Peter

    2012-09-01

    Pneumatic nail guns are a tool used commonly in the construction industry and are widely available. Accidental injuries from nail guns are common, and several cases of suicide using a nail gun have been reported. Computed tomographic (CT) imaging, together with echocardiography, has been shown to be the gold standard for investigation of these cases. We present a case of a 55-year-old man who presented to the accident and emergency unit of a community hospital following an accidental pneumatic nail gun injury to his thorax. Volume-rendered CT of the thorax allowed an accurate assessment of the thoracic injuries sustained by this patient. As there was no evidence of any acute life-threatening injury, a sternotomy was avoided and the patient was observed closely until discharge. In conclusion, volume-rendered 3-dimensional CT can greatly help in the decision to avoid an unnecessary sternotomy in patients with a thoracic nail gun injury.

  11. Thoracic Injuries in earthquake-related versus non-earthquake-related trauma patients: differentiation via Multi-detector Computed Tomography

    Science.gov (United States)

    Dong, Zhi-hui; Yang, Zhi-gang; Chen, Tian-wu; Chu, Zhi-gang; Deng, Wen; Shao, Heng

    2011-01-01

    PURPOSE: Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT). METHODS: We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT. RESULTS: The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR) = 2.2; pchest (45/143 vs. 11/66 patients, RR = 1.9; ptraumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries. PMID:21789386

  12. Computed tomography in radiation therapy planning: Thoracic region

    International Nuclear Information System (INIS)

    Seydel, H.G.; Zingas, A.; Haghbin, M.; Mondalek, P.; Smereka, R.

    1983-01-01

    With the explosive spread of computed tomographic (CT) scanning throughout the United States, one of the main applications has been in patients who are treated for cancer by surgery, radiation therapy, or chemotherapy. For the radiation oncologist, the desire to provide local tumor control and avoid geographic misses to achieve an expected prolongation of survival has led to the use of large radiation fields in the treatment of intrathoracic cancer, including bronchogenic carcinoma, cancer of the esophagus, and other malignant tumors. The optimal radiation therapy plan is a balance between local tumor control and the necessity to preserve normal structures by the use of directed and limited fields for bulk disease. CT scanning has been employed to accurately demonstrate the extent of tumor as well as to determine the isodose distribution of radiation, including the spatial distribution of radiation portals in single planar and three-dimensional aspects as well as consideration of tissue inhomogeneities. The accurate planning of the distribution of therapeutic irradiation includes both the tumor-bearing target volume and the critical normal tissues. This chapter provides information regarding these aspects of the application of CT scanning to radiation therapy for bronchogenic carcinoma and carcinoma of the esophagus

  13. Descending aortic injury by a thoracic pedicle screw during posterior reconstructive surgery: a case report.

    Science.gov (United States)

    Watanabe, Kei; Yamazaki, Akiyoshi; Hirano, Toru; Izumi, Tomohiro; Sano, Atsuki; Morita, Osamu; Kikuchi, Ren; Ito, Takui

    2010-09-15

    Case report. To describe an iatrogenic aortic injury by pedicle screw instrumentation during posterior reconstructive surgery of spinal deformity. Iatrogenic major vascular injuries during anterior instrumentation procedures have been reported by several authors, but there have been few reports regarding iatrogenic major vascular injuries during posterior instrumentation procedures. A 57-year-old woman with thoracolumbar kyphosis due to osteoporotic T12 vertebral fracture underwent posterior correction and fusion (T10-L2), using segmental pedicle screw construct concomitant with T12 pedicle subtraction osteotomy. Postoperative routine plain radiographs and computed tomography myelography demonstrated a misplaced left T10 pedicle screw, which was in contact with the posteromedial aspect of the thoracic aorta, and suspected penetration of the aortic wall. The patient underwent removal of the pedicle screw, and repair of the penetrated aortic wall through a simultaneous anterior-posterior approach. The patient tolerated the procedure well without neurologic sequelae, and was discharged several days after removal of a left tube thoracostomy. Plain radiographs demonstrated solid fusion at the osteotomy site and no loosening of hardware. Preoperative neurologic symptoms improved completely at 18-months follow-up. Use of pedicle screw instrumentation has the potential to cause major vascular injury during posterior spinal surgery, and measures to prevent this complication must be taken. Timely diagnosis and treatment are essential to prevent both early and delayed complications and death.

  14. When and how should we manage thoracic aortic injuries in the modern era?

    Science.gov (United States)

    Bottet, Benjamin; Bouchard, François; Peillon, Christophe; Baste, Jean-Marc

    2016-12-01

    A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was what are the optimum treatment modality and timing of intervention for blunt thoracic aortic injury (BTAI) in the modern era? Of the 697 papers found using the reported search, 14 (5 meta-analyses, 2 prospective and 7 retrospective studies) represented the best evidence to answer the clinical question. The author, journal, country, date of publication, patient group studied, study type, relevant outcomes, results and weakness of these papers are tabulated. All five meta-analyses reported a reduction in mortality with thoracic endovascular aortic repair (TEVAR) compared with open repair (OR), but only four found the same benefit on paraplegia rate. Similarly, the two prospective and four retrospective studies showed significantly lower mortality with TEVAR than with OR. Only one study (a meta-analysis) reported a significantly lower stroke rate with TEVAR than with OR, whereas the 13 others reported a similar or even higher stroke rate. Other complication rates were identical. Four studies demonstrated that non-operative management (NOM) as a treatment option for BTAI was associated with increased mortality, even if it has declined in recent years. One study emphasized that some cases with minimal aortic injuries (Grade I and II on CT scan) could benefit from NOM. Regarding the timing of repair, only three studies analysed outcomes of delayed repair and reported significantly lower mortality than for early repair. We conclude that with lower mortality and similar overall complications including paraplegia but higher stroke rate, TEVAR is the most suitable treatment for BTAI in the modern era, where expertise exists, especially for cases of multiple associated injuries and in the older age group. Delayed aortic repair can be proposed based on CT scan analysis, but emergent repair should still be advocated for imminent free aortic rupture. NOM

  15. Thoracic aortic injury in motor vehicle crashes: the effect of impact direction, side of body struck, and seat belt use.

    Science.gov (United States)

    Fitzharris, Michael; Franklyn, Melanie; Frampton, Richard; Yang, King; Morris, Andrew; Fildes, Brian

    2004-09-01

    Using in-depth, real-world motor vehicle crash data from the United States and the United Kingdom, we aimed to assess the incidence and risk factors associated with thoracic aorta injuries. De-identified National Automotive Sampling System Crashworthiness Data System (U.S.) and Co-operative Crash Injury Study (U.K.) data formed the basis of this retrospective analysis. Logistic regression was used to assess the level of risk of thoracic aorta injury associated with impact direction, seat belt use and, given the asymmetry of the thoracic cavity, whether being struck toward the left side of the body was associated with increased risk in side-impact crashes. A total of 13,436 U.S. and 3,756 U.K. drivers and front seat passengers were analyzed. The incidence of thoracic aorta injury in the U.S. and U.K. samples was 1.5% (n = 197) and 1.9% (n = 70), respectively. The risk was higher for occupants seated on the side closest to the impact than for occupants involved in frontal impact crashes. This was the case irrespective of whether the force was applied toward the left (belted: relative risk [RR], 4.6; 95% confidence interval [CI], 2.9-7.1; p direction. Thoracic aorta injuries were found to be associated with high impact severity, and being struck by a sports utility vehicle relative to a passenger vehicle (RR, 1.7; 95% CI, 1.2-2.3; p = 0.001). Aortic injuries have been conventionally associated with frontal impacts. However, emergency clinicians should be aware that occupants of side-impact crashes are at greater risk, particularly if the occupant was unbelted and involved in a crash of high impact severity.

  16. Role of contrast-enhanced helical CT in the evaluation of acute thoracic aortic injuries after blunt chest trauma

    International Nuclear Information System (INIS)

    Scaglione, M.; Pinto, A.; Pinto, F.; Romano, L.; Ragozzino, A.; Grassi, R.

    2001-01-01

    The purpose of this retrospective study was to determine the value of contrast-enhanced helical CT for detecting and managing acute thoracic aortic injury (ATAI). Between June 1995 and February 2000, 1419 consecutive chest CT examinations were performed in the setting of major blunt trauma. The following CT findings were considered indicative of ATAI: intimal flap; pseudoaneurysm; contour irregularity; lumen abnormality; and extravasation of contrast material. On the basis of these direct findings no further diagnostic investigations were performed. Isolated mediastinal hematoma on CT scans was considered an indirect sign of ATAI: In these cases, thoracic aortography was performed even if CT indicated normal aorta. Seventy-seven patients had abnormal CT scans: Among the 23 patients with direct CT signs, acute thoracic aortic injuries was confirmed at thoracotomy in 21. Two false-positive cases were observed. The 54 remaining patients had isolated mediastinal hematoma without aortic injuries at CT and corresponding negative angiograms. The 1342 patients with negative CT scans were included in the 8-month follow-up program and did not show any adverse sequela based on clinical and radiographic criteria. Contrast-enhanced helical CT has a critical role in the exclusion of thoracic aortic injuries in patient with major blunt chest trauma and prevents unnecessary thoracic aortography. Direct CT signs of ATAI do not require further diagnostic investigations to confirm the diagnosis: Isolated aortic bands or contour vessel abnormalities should be first considered as possible artifacts or related to non-traumatic etiologies especially when mediastinal hematoma is absent. In cases of isolated mediastinal hematoma other possible sources of bleeding should be considered before directing patients to thoracic aortography. (orig.)

  17. Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons

    Energy Technology Data Exchange (ETDEWEB)

    Melo, Alessandro Severo Alves de; Moreira, Luiza Beatriz Melo; Pessoa, Fernanda Miraldi Clement; Saint-Martin, Nara; Ancilotti Filho, Roger [Universidade Federal Fluminense (UFF), Niterói, RJ (Brazil); Souza Junior, Arthur Soares [Faculdade de Medicina de São José do Rio Preto (FAMERP), SP (Brazil); Marchiori, Edson, E-mail: edmarchiori@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2017-11-15

    Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%). Conclusion: In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach. (author)

  18. Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons

    Directory of Open Access Journals (Sweden)

    Alessandro Severo Alves de Melo

    2017-10-01

    Full Text Available Abstract Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8% were gunshot wounds and 5 (14.2% were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%, manifesting as contusions in 34 cases (85%, atelectasis in 8 (20%, lacerations in 1 (2.5% and hematomas in 1 (2.5%. Hemothorax was seen in 31 cases (77.5%, and pneumothorax was seen in 22 cases (55%. Mediastinal lesions were observed in 8 cases (20%, including mediastinal hematoma in 3 cases (7.5%, hemopericardium in 3 (7.5%, and pneumomediastinum in 2 (5%. Diaphragmatic rupture was seen in 2 cases (5%. Conclusion: In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach.

  19. Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons.

    Science.gov (United States)

    de Melo, Alessandro Severo Alves; Moreira, Luiza Beatriz Melo; Pessoa, Fernanda Miraldi Clemente; Saint-Martin, Nara; Ancilotti Filho, Roger; Souza, Arthur Soares; Marchiori, Edson

    2017-01-01

    The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%). In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach.

  20. Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons

    International Nuclear Information System (INIS)

    Melo, Alessandro Severo Alves de; Moreira, Luiza Beatriz Melo; Pessoa, Fernanda Miraldi Clement; Saint-Martin, Nara; Ancilotti Filho, Roger; Souza Junior, Arthur Soares; Marchiori, Edson

    2017-01-01

    Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%). Conclusion: In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach. (author)

  1. Radiation injuries of the oral cavity

    International Nuclear Information System (INIS)

    Galantseva, G.F.

    1982-01-01

    The review is given of factors which cause the beginning of radiation injuries of oral cavity in oncologic patients following radiotherapy: dose rate absorbed with tumor and surrounding healthy tissues; irradiation procedures; size of irradiated volume. Pathogenesis and clinical picture are considered as well as prophylaxis and tactics of treatments of patients with radiation injuries of oral cavity

  2. Mid-Thoracic Spinal Injuries during Horse Racing: Report of 3 Cases and Review of Causative Factors and Prevention Measurements

    Directory of Open Access Journals (Sweden)

    Ioannis Triantafyllopoulos

    2013-01-01

    Full Text Available We report three cases of a rare pattern of mid-thoracic spine injuries after horse racing falls and discuss possible causative factors and prevention measurements to reduce injury rates in professional riding and racing. Three patients, 2 male and 1 female with a mean age of 28 years old, underwent surgical treatment for mid-thoracic fractures after professional equestrian activities. The ASIA scale was E in one patient, B in the other one and A in the third. Multilevel posterior fusion was used in two patients and somatectomy plus fusion in the other. Follow up evaluation included changing of the ASIA scale, functional outcome and participation in equestrian activities. One patient fully recovered after surgery. Two patients remained paraplegic despite early surgical treatment and prolonged rehabilitation therapy. All patients had ended their professional equestrian career. This report analyzes possible mechanisms of injury and the pattern of mid-thoracic spine fractures after professional horse riding injuries. Despite skill improvements and continued safety education for horse riding, prophylactic measures for both the head and the spine should be refined. According to our study, additional mid-thoracic spinal protection should be added.

  3. Use of a dynamic gait trainer for a child with thoracic level spinal cord injury.

    Science.gov (United States)

    Altizer, Wendy; Noritz, Garey; Paleg, Ginny

    2017-10-10

    Paediatric spinal cord injury (SCI) can result in permanent mobility impairment with consequences for activity, participation and quality of life. This case documents the effect of an overground supported stepping intervention using a dynamic gait trainer. To our knowledge, there are no published studies on this intervention for children with SCI and similar interventions have only been reported in children at American Spinal Injury Association Impairment Scale (AIS) levels B and C.A child with a T10 (thoracic level, vertebra 10), AIS level A injury, sustained at 2 years of age, continued to make gains in all areas including participation, activity, body structure and function over the following 4 years. Use of a dynamic gait trainer improved the participant's ability to be active and participate despite lack of further neuromuscular recovery. This novel approach with a commonly available device allowed the child to be active and participate in the absence of neural recovery. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Thoracic Injuries in earthquake-related versus non-earthquake-related trauma patients: differentiation via Multi-detector Computed Tomography

    Directory of Open Access Journals (Sweden)

    Zhi-hui Dong

    2011-01-01

    Full Text Available PURPOSE: Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT. METHODS: We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT. RESULTS: The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR = 2.2; p<0.001. Among these patients, those with more than 3 fractured ribs (106/143 vs. 41/66 patients, RR=1.2; p<0.05 or flail chest (45/143 vs. 11/66 patients, RR=1.9; p<0.05 were more frequently seen in the earthquake cohort. Earthquake-related crush injuries more frequently resulted in bilateral rib fractures (66/143 vs. 18/66 patients, RR= 1.7; p<0.01. Additionally, the incidence of non-rib fracture was higher in the earthquake cohort (85 vs. 60 patients, RR= 1.4; p<0.01. Pulmonary parenchymal and pleural injuries were more frequently seen in earthquake-related crush injuries (117 vs. 80 patients, RR=1.5 for parenchymal and 146 vs. 74 patients, RR = 2.0 for pleural injuries; p<0.001. Non-rib fractures, pulmonary parenchymal and pleural injuries had significant positive correlation with rib fractures in these two cohorts. CONCLUSIONS: Thoracic crush traumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries.

  5. Securing safe and informative thoracic CT examinations—Progress of radiation dose reduction techniques

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Takeshi, E-mail: tkubo@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 (Japan); Ohno, Yoshiharu [Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan); Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan); Seo, Joon Beom [Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505 (Korea, Republic of); Yamashiro, Tsuneo [Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishinara, Okinawa 903-0215 (Japan); Kalender, Willi A. [Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Henkestr. 91, 91052 Erlangen (Germany); Lee, Chang Hyun [Department of Radiology, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul (Korea, Republic of); Lynch, David A. [Department of Radiology, National Jewish Health, 1400 Jackson St, A330 Denver, Colorado 80206 (United States); Kauczor, Hans-Ulrich [Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany); Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Im Neuenheimer Feld 400, 69120 Heidelberg (Germany); Hatabu, Hiroto, E-mail: hhatabu@partners.org [Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women' s Hospital, 75 Francis Street, Boston, MA 02115 (United States)

    2017-01-15

    Highlights: • Various techniques have led to substantial radiation dose reduction of chest CT. • Automatic modulation of tube current has been shown to reduce radiation dose. • Iterative reconstruction makes significant radiation dose reduction possible. • Processing time is a limitation for full iterative reconstruction, currently. • Validation of diagnostic accuracy is desirable for routine use of low dose protocols. - Abstract: The increase in the radiation exposure from CT examinations prompted the investigation on the various dose-reduction techniques. Significant dose reduction has been achieved and the level of radiation exposure of thoracic CT is expected to reach the level equivalent to several chest X-ray examinations. With more scanners with advanced dose reduction capability deployed, knowledge on the radiation dose reduction methods has become essential to clinical practice as well as academic research. This article reviews the history of dose reduction techniques, ongoing changes brought by newer technologies and areas of further investigation.

  6. Radiation injury to skeletal muscle

    International Nuclear Information System (INIS)

    Persons, C.C.M.; Wondergem, J.; Leer, J.W.H.

    1997-01-01

    Radiotherapy of neoplasia has increased the mean life expectancy of cancer patients. On the other hand, more reports are published on morbidity of the treatment with regard to normal tissue. Studies on skeletal muscle injury specifically are scarce, but many clinical long term follow-up studies make note of side effects as muscle atrophy, fibrosis and limited function. Furthermore it is suggested that skeletal muscles of children are more prone to radiation injury than those of adult subjects. Effects of radiation on skeletal muscle were studied in rats. On hind limb of young (100 g) and adult (350 g) rats was irradiated with single doses (15-30 Gy), while the other served as control. Follow-up was up to 12 months post treatment. Muscular function in young rats was decreased significantly at 6 months post irradiation, but did not further decrease in the following 6 months. The amount of collagen, on the other hand, was not increased at 6 months, but became highly elevated at 12 months past treatment. This suggests that at 6 months, impaired muscular function may not be explained by increased fibrotic tissues. This is an agreement with results obtained in adult rats, where function was also impaired, without concomitant increase in collagen. In an earlier study, mitochondrial oxygen consumption was dose dependently decreased after irradiation, at 12 months, but not at 6 months post treatment. Furthermore, myosin-actin interaction was measured in skinned fibers. The first results of this study indicate changes in the interaction of contraction proteins, as early as 6 months post treatment. (authors)

  7. Treatment outcomes of extended-field radiation therapy for thoracic superficial esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Doo Yeul; Moon, Sung Ho; Cho, Kwan Ho; Kim, Tae Hyun; Kim, Moon Soo; Lee, Jong Yeul; Suh, Yang Gun [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    2017-09-15

    To evaluate the efficacy and safety of extended-field radiation therapy for patients with thoracic superficial esophageal cancer (SEC). From May 2007 to October 2016, a total of 24 patients with thoracic SEC (T1a and T1b) who underwent definitive radiotherapy and were analyzed retrospectively. The median total radiotherapy dose was 64 Gy (range, 54 to 66 Gy) in conventional fractionation. All 24 patients received radiotherapy to whole thoracic esophagus and 23 patients received elective nodal irradiation. The supraclavicular lymph nodes, the celiac lymph nodes, and both of those nodal areas were included in 11, 3, and 9 patients, respectively. The median follow-up duration was 28.7 months (range 7.9 to 108.0 months). The 3-year overall survival, local control, and progression-free survival rates were 95.2%, 89.7%, and 78.7%, respectively. There were 5 patients (20.8%) with progression of disease, 2 local failures (8.3%) and 3 (12.5%) regional failures. Three patients also experienced distant metastasis and had died of disease progression. There were no treatment-related toxicities of grade 3 or higher. Definitive extended-field radiotherapy for thoracic SEC showed durable disease control rates in medically inoperable and endoscopically unfit patients. Even extended-field radiotherapy with elective nodal irradiation was safe without grade 3 or 4 toxicities.

  8. Treatment outcomes of extended-field radiation therapy for thoracic superficial esophageal cancer

    International Nuclear Information System (INIS)

    Lee, Doo Yeul; Moon, Sung Ho; Cho, Kwan Ho; Kim, Tae Hyun; Kim, Moon Soo; Lee, Jong Yeul; Suh, Yang Gun

    2017-01-01

    To evaluate the efficacy and safety of extended-field radiation therapy for patients with thoracic superficial esophageal cancer (SEC). From May 2007 to October 2016, a total of 24 patients with thoracic SEC (T1a and T1b) who underwent definitive radiotherapy and were analyzed retrospectively. The median total radiotherapy dose was 64 Gy (range, 54 to 66 Gy) in conventional fractionation. All 24 patients received radiotherapy to whole thoracic esophagus and 23 patients received elective nodal irradiation. The supraclavicular lymph nodes, the celiac lymph nodes, and both of those nodal areas were included in 11, 3, and 9 patients, respectively. The median follow-up duration was 28.7 months (range 7.9 to 108.0 months). The 3-year overall survival, local control, and progression-free survival rates were 95.2%, 89.7%, and 78.7%, respectively. There were 5 patients (20.8%) with progression of disease, 2 local failures (8.3%) and 3 (12.5%) regional failures. Three patients also experienced distant metastasis and had died of disease progression. There were no treatment-related toxicities of grade 3 or higher. Definitive extended-field radiotherapy for thoracic SEC showed durable disease control rates in medically inoperable and endoscopically unfit patients. Even extended-field radiotherapy with elective nodal irradiation was safe without grade 3 or 4 toxicities

  9. Predicting Radiation Pneumonitis After Stereotactic Ablative Radiation Therapy in Patients Previously Treated With Conventional Thoracic Radiation Therapy

    International Nuclear Information System (INIS)

    Liu Hui; Zhang Xu; Vinogradskiy, Yevgeniy Y.; Swisher, Stephen G.; Komaki, Ritsuko; Chang, Joe Y.

    2012-01-01

    Purpose: To determine the incidence of and risk factors for radiation pneumonitis (RP) after stereotactic ablative radiation therapy (SABR) to the lung in patients who had previously undergone conventional thoracic radiation therapy. Methods and Materials: Seventy-two patients who had previously received conventionally fractionated radiation therapy to the thorax were treated with SABR (50 Gy in 4 fractions) for recurrent disease or secondary parenchymal lung cancer (T 10 and mean lung dose (MLD) of the previous plan and the V 10 -V 40 and MLD of the composite plan were also related to RP. Multivariate analysis revealed that ECOG PS scores of 2-3 before SABR (P=.009), FEV1 ≤65% before SABR (P=.012), V 20 ≥30% of the composite plan (P=.021), and an initial PTV in the bilateral mediastinum (P=.025) were all associated with RP. Conclusions: We found that severe RP was relatively common, occurring in 20.8% of patients, and could be predicted by an ECOG PS score of 2-3, an FEV1 ≤65%, a previous PTV spanning the bilateral mediastinum, and V 20 ≥30% on composite (previous RT+SABR) plans. Prospective studies are needed to validate these predictors and the scoring system on which they are based.

  10. Thoracic epidural analgesia reduces myocardial injury in ischemic patients undergoing major abdominal cancer surgery

    Directory of Open Access Journals (Sweden)

    Mohamad MF

    2017-04-01

    Full Text Available Mohamad Farouk Mohamad,1 Montaser A Mohammad,1 Diab F Hetta,1 Eman Hasan Ahmed,2 Ahmed A Obiedallah,3 Alaa Ali M Elzohry1 1Department of Anesthesia, ICU and Pain Relief, 2Department of Clinical Pathology, South Egypt Cancer Institute, 3Department of Internal Medicine, Faculty of Medicine, Assiut University, Arab Republic of Egypt Background and objectives: Major abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery.Patients and methods: One hundred and twenty patients (American Society of Anesthesiologists grade II and III of either sex were scheduled for elective upper gastrointestinal cancer surgeries. Patients were allocated randomly into two groups (60 patients each to receive, besides general anesthesia: continuous intra and postoperative intravenous (IV infusion with fentanyl for 72 h postoperatively (patient controlled intravenous analgesia [PCIA] group or continuous intra and postoperative epidural infusion with bupivacaine 0.125% and fentanyl (PCEA group for 72 h postoperatively. Perioperative hemodynamics were recorded. Postoperative pain was assessed over 72 h using visual analog scale (VAS. All patients were screened for occurrence of myocardial injury (MI by electrocardiography, echocardiography, and cardiac troponin I serum level. Other postoperative complications as arrhythmia, deep venous thrombosis (DVT, pulmonary embolism, pneumonia, and death were recorded.Results: There was a significant reduction in overall adverse cardiac events (myocardial injury, arrhythmias, angina, heart failure and nonfatal cardiac arrest in PCEA group in comparison to PCIA group. Also, there was a significant reduction in dynamic VAS pain score in group PCEA in comparison

  11. Radiation injury claims: an overview and update

    International Nuclear Information System (INIS)

    Schaffer, W.G.

    1984-01-01

    The author reviews the radiation injury claims problem and summarizes the legal framework in which the claims are presently brought. Two cases are reviewed in which the decisions are troubling. The implications of these decisions are discussed in the overall radiation injury claims problem. The author notes that in the largest radiation injury case tried in the United States, the court was unable to resolve the claims within the confines of the existing law. The disregard for established norms of adjudication and the resultant decline in predictability of outcome portends grave consequences, not only for the nuclear industry but for other industries involved with potentially toxic substances

  12. Thoracic radiation therapy before autologous bone marrow transplantation in relapsed or refractory Hodgkin's disease

    International Nuclear Information System (INIS)

    Tsang, R.W.; Gospodarowicz, M.K.; Sutcliffe, S.B.; Crump, M.; Keating, A.

    1999-01-01

    The aim of this study was to assess the relationship between radiation therapy (RT) and treatment-related mortality in patients receiving high-dose chemotherapy (HDCT) and autologous bone marrow transplantation (ABMT) for recurrent/refractory Hodgkin's disease (HD). Between December 1986 and December 1992, 59 patients previously treated at the Princess Margaret Hospital underwent HDCT (etoposide 60 mg/kg, melphalan 160 mg/m 2 ) and ABMT, performed for refractory (13 patients) or relapsed (46 patients) HD. RT was incorporated in the salvage treatment with the intent to achieve complete control of disease prior to ABMT. RT was given before ABMT in 33 patients, and after ABMT in 4 patients. Treatment-related (TR) mortality was defined as any death occurring within 100 days of ABMT. Autopsies were performed for all patients with TR deaths. With a median follow-up of 4.6 years (range 1.2-7.4 years), the actuarial overall survival was 41%±14% at 5 years. We observed 37 deaths, and 10 of these were TR deaths. Among the 24 patients who received thoracic RT before ABMT, there were 8 TR deaths, 3 of these solely attributable to radiation pneumonitis. The remaining 5 TR deaths all had respiratory failure with complicating sepsis as a major medical problem. The interval from RT to ABMT was shorter for 8 patients dying of TR death (mean 37 days; range 0-103 days), than for the 16 survivors (mean 105 days; range 0-263 days) (P=0.026). Among 9 patients with ABMT within 50 days of thoracic RT, 6 had TR death. In contrast, among the 35 patients without thoracic RT (26 no RT, 9 non-thoracic RT), there were only 2 TR deaths. The 4 patients treated with mantle RT post-ABMT had no serious pulmonary complications. The use of thoracic RT before HDCT and ABMT was associated with a high post-transplant mortality rate. It was most evident in patients who received thoracic RT within 50 days prior to ABMT, or when the target volume included large volume of lung. We recommend that the use of

  13. The utility of chest X-ray as a screening tool for blunt thoracic aortic injury.

    Science.gov (United States)

    Gutierrez, Adam; Inaba, Kenji; Siboni, Stefano; Effron, Zachary; Haltmeier, Tobias; Jaffray, Paul; Reddy, Sravanthi; Lofthus, Alexander; Benjamin, Elizabeth; Dubose, Joseph; Demetriades, Demetrios

    2016-01-01

    The early and accurate identification of patients with blunt thoracic aortic injury (BTAI) remains a challenge. Traditionally, a portable AP chest X-ray (CXR) is utilized as the initial screening modality for BTAI, however, there is controversy surrounding its sensitivity. The purpose of this study was to assess the sensitivity of CXR as a screening modality for BTAI. After IRB approval, all adult (≥18 yo) blunt trauma patients admitted to LAC+USC (01/2011-12/2013) who underwent CXR and chest CT were retrospectively reviewed. Final radiology attending CXR readings were reviewed for mediastinal abnormalities (widened mediastinum, mediastinal to chest width ratio greater than 0.25, irregular aortic arch, blurred aortic contour, opacification of the aortopulmonary window, and apical pleural haematoma) suggestive of aortic injury. Chest CT final attending radiologist readings were utilized as the gold standard for diagnosis of BTAI. The primary outcome analyzed was CXR sensitivity. A total of 3728 patients were included in the study. The majority of patients were male (72.6%); mean age was 43 (SD 20). Median ISS was 9 (IQR 4-17) and median GCS was 15 (IQR 14-15). The most common mechanism of injury was MVC (48.0%), followed by fall (20.6%), and AVP (16.9%). The total number of CXRs demonstrating a mediastinal abnormality was 200 (5.4%). Widened mediastinum was present on 191 (5.1%) of CXRs, blurred aortic contour on 10 (0.3%), and irregular aortic arch on 4 (0.1%). An acute aortic injury confirmed by chest CT was present in 17 (0.5%) patients. Only 7 of these with CT-confirmed BTAI had a mediastinal abnormality identified on CXR, for a sensitivity of 41% (95% CI: 19-67%). The results from this study suggest that CXR alone is not a reliable screening modality for BTAI. A combination of screening CXR and careful consideration of other factors, such as mechanism of injury, will be required to effectively discriminate between those who should and should not undergo chest

  14. Combination of radiation injuries: pathogenesis, clinic, therapy

    International Nuclear Information System (INIS)

    Tsyba, A.F.; Farshatova, M.N.

    1993-01-01

    Modern notions on combined radiation injuries (CRI) are presented. Characteristic of injurious factors of nuclear explosion and common regularities of the CRI origination is given. The data on the CRI clinical peculiarities, diagnostics and treatment, principles of medical assistance for the injured on the stages of medical evacuation and recommendations on rehabilitation are presented

  15. Role of sphingolipids in murine radiation-induced lung injury: protection by sphingosine 1-phosphate analogs

    OpenAIRE

    Mathew, Biji; Jacobson, Jeffrey R.; Berdyshev, Evgeny; Huang, Yong; Sun, Xiaoguang; Zhao, Yutong; Gerhold, Lynnette M.; Siegler, Jessica; Evenoski, Carrie; Wang, Ting; Zhou, Tong; Zaidi, Rafe; Moreno-Vinasco, Liliana; Bittman, Robert; Chen, Chin Tu

    2011-01-01

    Clinically significant radiation-induced lung injury (RILI) is a common toxicity in patients administered thoracic radiotherapy. Although the molecular etiology is poorly understood, we previously characterized a murine model of RILI in which alterations in lung barrier integrity surfaced as a potentially important pathobiological event and genome-wide lung gene mRNA levels identified dysregulation of sphingolipid metabolic pathway genes. We hypothesized that sphingolipid signaling components...

  16. Penetrating injury to the chest by an attenuated energy projectile: a case report and literature review of thoracic injuries caused by "less-lethal" munitions

    Directory of Open Access Journals (Sweden)

    Porto Leonardo BO

    2009-06-01

    Full Text Available Abstract We present the case of a patient who sustained a penetrating injury to the chest caused by an attenuated energy rubber bullet and review the literature on thoracic injuries caused by plastic and rubber "less-lethal" munitions. The patient of this report underwent a right thoracotomy to extract the projectile as well as a wedge resection of the injured lung parenchyma. This case demonstrates that even supposedly safe riot control munition fired at close range, at the torso, can provoke serious injury. Therefore a thorough investigation and close clinical supervision are justified.

  17. Penetrating injury to the chest by an attenuated energy projectile: a case report and literature review of thoracic injuries caused by "less-lethal" munitions.

    Science.gov (United States)

    Rezende-Neto, Joao; Silva, Fabriccio Df; Porto, Leonardo Bo; Teixeira, Luiz C; Tien, Homer; Rizoli, Sandro B

    2009-06-26

    We present the case of a patient who sustained a penetrating injury to the chest caused by an attenuated energy rubber bullet and review the literature on thoracic injuries caused by plastic and rubber "less-lethal" munitions. The patient of this report underwent a right thoracotomy to extract the projectile as well as a wedge resection of the injured lung parenchyma. This case demonstrates that even supposedly safe riot control munition fired at close range, at the torso, can provoke serious injury. Therefore a thorough investigation and close clinical supervision are justified.

  18. Risk factors of significant pain syndrome 90 days after minor thoracic injury: trajectory analysis.

    Science.gov (United States)

    Daoust, Raoul; Emond, Marcel; Bergeron, Eric; LeSage, Natalie; Camden, Stéphanie; Guimont, Chantal; Vanier, Laurent; Chauny, Jean-Marc

    2013-11-01

    The objective was to identify the risk factors of clinically significant pain at 90 days in patients with minor thoracic injury (MTI) discharged from the emergency department (ED). A prospective, multicenter, cohort study was conducted in four Canadian EDs from November 2006 to November 2010. All consecutive patients aged 16 years or older with MTI were eligible at discharge from EDs. They underwent standardized clinical and radiologic evaluations at 1 and 2 weeks, followed by standardized telephone interviews at 30 and 90 days. A pain trajectory model characterized groups of patients with different pain evolutions and ascertained specific risk factors in each group through multivariate analysis. In this cohort of 1,132 patients, 734 were eligible for study inclusion. The authors identified a pain trajectory that characterized 18.2% of the study population experiencing clinically significant pain (>3 of 10) at 90 days after a MTI. Multivariate modeling found two or more rib fractures, smoking, and initial oxygen saturation below 95% to be predictors of this group of patients. To the authors' knowledge, this is the first prospective study of trajectory modeling to detect risk factors associated with significant pain at 90 days after MTI. These factors may help in planning specific treatment strategies and should be validated in another prospective cohort. © 2013 by the Society for Academic Emergency Medicine.

  19. Transient long thoracic nerve injury during posterior spinal fusion for adolescent idiopathic scoliosis: A report of two cases

    Directory of Open Access Journals (Sweden)

    Athanasios I Tsirikos

    2013-01-01

    Full Text Available We present the transient long thoracic nerve (LTN injury during instrumented posterior spinal arthrodesis for idiopathic scoliosis. The suspected mechanism of injury, postoperative course and final outcome is discussed. The LTN is susceptible to injury due to its long and relatively superficial course across the thoracic wall through direct trauma or tension. Radical mastectomies with resection of axillary lymph nodes, first rib resection to treat thoracic outlet syndrome and cardiac surgery can be complicated with LTN injury. LTN injury producing scapular winging has not been reported in association with spinal deformity surgery. We reviewed the medical notes and spinal radiographs of two adolescent patients with idiopathic scoliosis who underwent posterior spinal arthrodesis and developed LTN neuropraxia. Scoliosis surgery was uneventful and intraoperative spinal cord monitoring was stable throughout the procedure. Postoperative neurological examination was otherwise normal, but both patients developed winging of the scapula at 4 and 6 days after spinal arthrodesis, which did not affect shoulder function. Both patients made a good recovery and the scapular winging resolved spontaneously 8 and 11 months following surgery with no residual morbidity. We believe that this LTN was due to positioning of our patients with their head flexed, tilted and rotated toward the contralateral side while the arm was abducted and extended. The use of heavy retractors may have also applied compression or tension to the nerve in one of our patients contributing to the development of neuropraxia. This is an important consideration during spinal deformity surgery to prevent potentially permanent injury to the nerve, which can produce severe shoulder dysfunction and persistent pain.

  20. Challenges in war-related thoracic injury faced by French military surgeons in Afghanistan (2009-2013).

    Science.gov (United States)

    de Lesquen, Henri; Beranger, Fabien; Berbis, Julie; Boddaert, Guillaume; Poichotte, Antoine; Pons, Francois; Avaro, Jean-Philippe

    2016-09-01

    This study reports the challenges faced by French military surgeons in the management of thoracic injury during the latest Afghanistan war. From January 2009 to April 2013, all of the civilian, French and Coalition casualties admitted to French NATO Combat Support Hospital situated on Kabul were prospectively recorded in the French Military Health Service Registry (OPEX(®)). Only penetrating and blunt thoracic trauma patients were retrospectively included. Eighty-nine casualties were included who were mainly civilian (61%) and men (94%) with a mean age of 27.9 years old. Surgeons dealt with polytraumas (78%), severe injuries (mean Injury Severity Score=39.2) and penetrating wounds (96%) due to explosion in 37%, gunshot in 53% and stabbing in 9%. Most of casualties were first observed or drained (n=56). In this non-operative group more than 40% of casualties needed further actions. In the operative group, Damage Control Thoracotomy (n=22) was performed to stop ongoing bleeding and air leakage and Emergency Department Thoracotomy (n=11) for agonal patient. Casualties suffered from hemothorax (60%), pneumothorax (39%), diaphragmatic (37%), lung (35%), heart or great vessels (20%) injuries. The main actions were diaphragmatic sutures (n=25), lung resections (wedge n=6, lobectomy n=4) and haemostasis (intercostal artery ligation n=3, heart injury repairs n=5, great vessels injury repairs n=5). Overall mortality was 11%. The rate of subsequent surgery was 34%. The analysis of the OPEX(®) registry reflects the thoracic surgical challenges of general (visceral) surgeons serving in combat environment during the latest Afghanistan War. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. The history of knowledge on radiation injuries

    International Nuclear Information System (INIS)

    Schuettmann, W.

    1988-01-01

    The possible endangering with the peaceful utilization of nuclear energy and the fateful threat of mankind by nuclear weapons in a world-wide extent keep the discussion on problems of radiation injuries and the national and international activities to avoid them as well running. In view of the burning discussions, the impression may rise that radiation injuries became aware to the human-being only recently. Actually this knowledge dats back to the turn of the century. The development of the knowledge on radiation injuries originating immediately after discovery of W.C. Roentgen in 1895 is presented concisely. The application of radiotherapy is taken into consideration. A historical retrospect in various sections deals with the initial period of radiogenic skin injuries, with the recognition of radiation injuries at the internal organs, the proof of carcinogenic effects of ionizing radiations and its mutagenic influence. Finally it is presented how experience gained during decades, is used as a basis for the conception of present radiation protection. (author)

  2. Radiation injury caused by internal contamination

    International Nuclear Information System (INIS)

    Petyrek, P.

    1988-01-01

    Basic data are given of radiation injury of the respiratory organs, digestive tract, hematogenous tissues and the thyroid due to internal contamination. Attention is drawn to the complexity of the problem and to the effect of the various factors affecting the picture and course of the radiation damage. The treatment is based on the assumption that fundamental is the damage of the stem cells of the critical organs. Discussed are also the basic clinical pictures that can occur due to internal contamination with activities causing radiation injury. (B.S.). 27 refs

  3. Diagnosis and treatment of radiation injuries

    International Nuclear Information System (INIS)

    Dalci, D.; Doerter, G.; Gueclue, I.

    2005-01-01

    This publication is the translation of IAEA Safety Reports Series No.2 ,Diagnosis and Treatment of Radiation Injuries. This report is directed at medical professionals who may be involved in the management of radiation injuries starting from the first few hours or days after an exposure of undefined severity. The principal aim of this publication is to provide guidelines to enable medical professionals to carry out prompt diagnostic measure and to offer emergency treatment. This report provides information in tabulated form on clinical criteria for dose assesment. Additionally, it discusses the appropriate dose-effect relationship in cases of external radiation involving either total body or local exposures, as well as internal contamination

  4. Diagnostic modalities x-ray and CT chest differ in the management of thoracic injury

    Directory of Open Access Journals (Sweden)

    D Chapagain

    2015-06-01

    Full Text Available Objective: To observe difference in the management of blunt trauma to the chest on the basis of conventional xray and computerised tomography of the chest. Methods: This prospective study was conducted between December 2011 to October 2012 in COMS in Bharatpur,a tertiary referral centre in central Nepal . Clinically stable thoracic injury patients were first evaluated with chest x-ray and the management on this basis was recorded. The findings of the CT chest were assessed and the type of management on the basis of CT was also recorded. Outcome was assessed in terms of mortality, morbidity, hospital and ICU stay with respect to the management on the basis of chest x-ray and CT scan. Results: Of the 129 patients, 74.4% were male and 25.6% were female with the patients ranging in age from 7 to 87 years (mean = 40.41 years. The most common mechanism of trauma to the chest was as a result of a motor vehicle accident (69.8%, followed by fall injury (20.2%. X-ray chest diagnosed rib fracture in 62%, haemothorax in 37%, pneumothorax in 27%, lung contusion in 10% and haemopneumothorax in 21% patients. Similarly CT chest diagnosed rib fracture in 86%, haemothorax in 54%, pneumothorax in 36%, lung contusion in 30% and haemopneumothorax in 30% patients. Mean hospital stay was 9.5 days in the group of patients having management on the basis of x-ray chest relative to mean stay of 10.2 days in the CT- chest group. In the management on the basis of xray group, there was a mean ICU stay of 2.8days compared to mean stays of 3.2 days in CT chest group. Conclusion: Though CT scan of the chest is more informative and differs the management of the blunt chest trauma, one should not forget to advise the cost effective, easily available and initial guiding agent, xray chest for early management of the chest injury patient. DOI: http://dx.doi.org/10.3126/jcmsn.v10i1.12764 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(1; 22-31

  5. Effects of wheelchair sports on respiratory muscle strength and thoracic mobility of individuals with spinal cord injury.

    Science.gov (United States)

    Moreno, Marlene Aparecida; Zamunér, Antonio Roberto; Paris, Juliana Viana; Teodori, Rosana Macher; Barros, Ricardo M L

    2012-06-01

    The aim of this study was to evaluate the effects of wheelchair sports on respiratory muscle strength and the thoracic mobility of individuals with spinal cord injury. Thirty male subjects with chronic spinal cord injury (American Spinal Injury Association Impairment Scale grade A) took part in the study and were divided into four groups: sedentary subjects with quadriplegia (S-QUAD, n = 7), wheelchair rugby athletes with quadriplegia (A-QUAD, n = 8), sedentary subjects with paraplegia (S-PARA, n = 6), and wheelchair basketball athletes with paraplegia (A-PARA, n = 9). The main outcome measures were maximal inspiratory and expiratory pressure and the respiratory coefficients at the axillary and xiphoid levels. A-QUAD group presented values significantly higher for all respiratory variables studied compared with the S-QUAD group. No significant differences in any of the respiratory variables were observed between S-PARA and A-PARA groups. There was a negative correlation between spinal cord injury level and respiratory variables for the S-QUAD and S-PARA groups. There were positive correlations in the A-QUAD group between time of training and maximal inspiratory pressure (adjusted R = 0.84; P = 0.001) and respiratory coefficients at the axillary level (adjusted R = 0.80; P = 0.002). Physical training seems to have a positive influence on respiratory muscle strength and thoracic mobility, especially in subjects with quadriplegia.

  6. Thoracic rat spinal cord contusion injury induces remote spinal gliogenesis but not neurogenesis or gliogenesis in the brain.

    Directory of Open Access Journals (Sweden)

    Steffen Franz

    Full Text Available After spinal cord injury, transected axons fail to regenerate, yet significant, spontaneous functional improvement can be observed over time. Distinct central nervous system regions retain the capacity to generate new neurons and glia from an endogenous pool of progenitor cells and to compensate neural cell loss following certain lesions. The aim of the present study was to investigate whether endogenous cell replacement (neurogenesis or gliogenesis in the brain (subventricular zone, SVZ; corpus callosum, CC; hippocampus, HC; and motor cortex, MC or cervical spinal cord might represent a structural correlate for spontaneous locomotor recovery after a thoracic spinal cord injury. Adult Fischer 344 rats received severe contusion injuries (200 kDyn of the mid-thoracic spinal cord using an Infinite Horizon Impactor. Uninjured rats served as controls. From 4 to 14 days post-injury, both groups received injections of bromodeoxyuridine (BrdU to label dividing cells. Over the course of six weeks post-injury, spontaneous recovery of locomotor function occurred. Survival of newly generated cells was unaltered in the SVZ, HC, CC, and the MC. Neurogenesis, as determined by identification and quantification of doublecortin immunoreactive neuroblasts or BrdU/neuronal nuclear antigen double positive newly generated neurons, was not present in non-neurogenic regions (MC, CC, and cervical spinal cord and unaltered in neurogenic regions (dentate gyrus and SVZ of the brain. The lack of neuronal replacement in the brain and spinal cord after spinal cord injury precludes any relevance for spontaneous recovery of locomotor function. Gliogenesis was increased in the cervical spinal cord remote from the injury site, however, is unlikely to contribute to functional improvement.

  7. Intentional left subclavian artery coverage during thoracic endovascular aortic repair for traumatic aortic injury.

    Science.gov (United States)

    McBride, Cameron L; Dubose, Joseph J; Miller, Charles C; Perlick, Alexa P; Charlton-Ouw, Kristofer M; Estrera, Anthony L; Safi, Hazim J; Azizzadeh, Ali

    2015-01-01

    Thoracic endovascular aortic repair (TEVAR) is widely used for treatment of traumatic aortic injury (TAI). Stent graft coverage of the left subclavian artery (LSA) may be required in up to 40% of patients. We evaluated the long-term effects of intentional LSA coverage (LSAC) on symptoms and return to normal activity in TAI patients compared with a similarly treated group whose LSA was uncovered (LSAU). Patients were identified from a prospective institutional trauma registry between September 2005 and July 2012. TAI was confirmed using computed tomography angiography. The electronic medical records, angiograms, and computed tomography angiograms were reviewed in a retrospective fashion. In-person or telephone interviews were conducted using the SF-12v2 (Quality Metrics, Lincoln, RI) to assess quality of life. An additional questionnaire was used to assess specific LSA symptoms and the ability to return to normal activities. Data were analyzed by Spearman rank correlation and multiple linear and logistic regression analysis with appropriate transformations using SAS software (SAS Institute, Cary, NC). During the study period, 82 patients (57 men; mean age 40.5 ± 20 years, mean Injury Severity Score, 34 ± 10.0) underwent TEVAR for treatment of TAI. Among them, LSAC was used in 32 (39.5%) and LSAU in 50. A group of the LSAU patients (n = 22) served as matched controls in the analysis. We found no statistically significant difference in SF-12v2 physical health scores (ρ = -0.08; P = .62) between LSAC and LSAU patients. LSAC patients had slightly better mental health scores (ρ = 0.62; P = .037) than LSAU patients. LSAC patients did not have an increased likelihood of experiencing pain (ρ = -0.0056; P = .97), numbness (ρ = -0.12; P = .45), paresthesia (ρ = -0.11; P = .48), fatigue (ρ = -0.066; P = .69), or cramping (ρ = -0.12; P = .45). We found no difference between groups in the ability to return to activities. The mean follow-up time was 3.35 years. Six LSAC

  8. Substances stimulating recovery for radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, A; Yonezawa, M; Katoh, N [Radiation Center of Osaka Prefecture, Sakai (Japan)

    1978-11-01

    A relationship between radiation injury and its recovery (intracellular recovery, intercellular recovery, or individual recovery) was discussed. In addition to histological researches in Japan, some substances (free radicals, endotoxin, vaccine, crude drugs, tissue extracts, blood platelet, etc.) stimulating recovery for radiation injury were introduced, and the progress of the study by the authors was summarized. Effects of a root of Panax ginseng (it is believed to accelerate segmentation of marrow cells, and synthesis of DNA and protein in rats and men), methods of its extracting and administration, its influences upon hemogram and organ weight in animal experiments, exclusion of side effects, period of administration, and purification of its effective components were reported.

  9. Radiation-induced heart injury. Radiopathological study

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Y; Niibe, H [Gunma Univ., Maebashi (Japan). School of Medicine

    1975-11-01

    In order to identify radiation-induced heart injury and to differentiate it from heart disease, an attempt was made to clarify post-irradiation heart injury by investigating the histological changes which occur during the interval between the irradiation and the time of demonstrable histological changes. A study was made of 83 autopsies in which most of the primary neoplasms were breast cancers, lung cancers and mediastinal tumors. In 43 of these autopsies the heart had been irradiated. Sixty eight dd-strain mice were also used for microautoradiographic study. Histological changes in the heart were observed in 27 of the 43 cases receiving irradiation. The limit of the tolerance dose to the heart for indicating histological changes was 1220 ret in humans. The latent period without histological changes was 2.7 months after initiation of radiation therapy. Greater heart injury was observed after re-irradiation or after the combined therapy of radiation and chemotherapy especially mitomycin (MMC). The histological findings after treatment with MMC were similar to those of radiation-induced heart injury. Results of the study indicate that the damage is secondary to radiation-induced changes of the vascula connective tissue.

  10. Surgical treatment of intestinal radiation injury

    International Nuclear Information System (INIS)

    Maekelae, J.Ne.; Nevasaari, K.; Kairaluoma, M.I.

    1987-01-01

    A review of 43 consecutive patients requiring operation for serious intestinal radiation injury was undertaken to elucidate the efficacy of surgical treatment. The most common site of radiation injury was the rectum (19 cases), followed by the small bowel (13 cases), the colon (7 cases), and the combination of these (4 cases). The overall operative mortality was 14%; morbidity, 47%; and the postoperative symptom-free period, 18 +/- 30 months. Colostomy (N = 20) carried the lowest risk of mortality, 0%, as compared with resection (N = 17) and bypass procedure (N = 6), which were accompanied by the mortalities of 24% and 33%, respectively. During the follow-up (3-13 years) 12 patients (28%) died of recurrent cancer and 9 patients (21%) of persistent radiation injury, which yielded an overall mortality of 65% after resection and 50% and 65% after bypass and colostomy procedures, respectively. Continuing radiation damage led to 15 late reoperations. Ten of these were performed after colostomy, four after resection, and one after bypass. We conclude that colostomy cannot be regarded as a preferred operative method, because it does not prevent the progression of radiation injury and because it is, for this reason, associated with a higher late-complication rate. A more radical surgery is recommended but with the limitation that the operative method must be adapted to the operative finding

  11. Obesity Increases the Risk of Chest Wall Pain From Thoracic Stereotactic Body Radiation Therapy

    International Nuclear Information System (INIS)

    Welsh, James; Thomas, Jimmy; Shah, Deep; Allen, Pamela K.; Wei, Xiong; Mitchell, Kevin; Gao, Song; Balter, Peter; Komaki, Ritsuko; Chang, Joe Y.

    2011-01-01

    Purpose: Stereotactic body radiation therapy (SBRT) is increasingly being used to treat thoracic tumors. We attempted here to identify dose-volume parameters that predict chest wall toxicity (pain and skin reactions) in patients receiving thoracic SBRT. Patients and Methods: We screened a database of patients treated with SBRT between August 2004 and August 2008 to find patients with pulmonary tumors within 2.5 cm of the chest wall. All patients received a total dose of 50 Gy in four daily 12.5-Gy fractions. Toxicity was scored according to the NCI-CTCAE V3.0. Results: Of 360 patients in the database, 265 (268 tumors) had tumors within 30 , or volume of the chest wall receiving 30 Gy. Body mass index (BMI) was also strongly associated with the development of chest pain: patients with BMI ≥29 had almost twice the risk of chronic pain (p = 0.03). Among patients with BMI >29, diabetes mellitus was a significant contributing factor to the development of chest pain. Conclusion: Safe use of SBRT with 50 Gy in four fractions for lesions close to the chest wall requires consideration of the chest wall volume receiving 30 Gy and the patient's BMI and diabetic state.

  12. Incidence of radiation pneumonitis after thoracic irradiation: Dose-volume correlates

    International Nuclear Information System (INIS)

    Schallenkamp, John M.; Miller, Robert C.; Brinkmann, Debra H.; Foote, Tyler; Garces, Yolanda I.

    2007-01-01

    Purpose: To define clinical and dosimetric parameters correlated with the risk of clinically relevant radiation pneumonitis (RP) after thoracic radiotherapy. Methods and Materials: Records of consecutive patients treated with definitive thoracic radiotherapy were retrospectively reviewed for the incidence of RP of Grade 2 or greater by the Common Toxicity Criteria. Dose-volume histograms using total lung volume (TL) and TL minus gross tumor volume (TL-G) were created with and without heterogeneity corrections. Mean lung dose (MLD), effective lung volume (V eff ), and percentage of TL or TL-G receiving greater than or equal to 10, 13, 15, 20, and 30 Gy (V10-V30, respectively) were analyzed by logistic regression. Receiver operating characteristic (ROC) curves were generated to estimate RP predictive values. Results: Twelve cases of RP were identified in 92 eligible patients. Mean lung dose, V10, V13, V15, V20, and V eff were significantly correlated to RP. Combinations of MLD, V eff , V20, and V30 lost significance using TL-G and heterogeneity corrections. Receiver operating characteristic analysis determined V10 and V13 as the best predictors of RP risk, with a decrease in predictive value above those volumes. Conclusions: Intrathoracic radiotherapy should be planned with caution when using radiotherapy techniques delivering doses of 10 to 15 Gy to large lung volumes

  13. Parenteral nutrition in radiation injuries

    International Nuclear Information System (INIS)

    Glants, R.M.

    1985-01-01

    Basing on the results of experiments on mice and rats and their clinical use in oncological patients treatment recommendations are given on use of parenteral nutrition in treatment of radiation disease

  14. Platinum-based chemotherapy with or without thoracic radiation therapy in patients with unresectable thymic carcinoma

    International Nuclear Information System (INIS)

    Nakamura, Yoichi; Kunitoh, Hideo; Kubota, Kaoru

    2000-01-01

    Thymic carcinoma is a rare mediastinal neoplasm with poor prognosis. Although the clinical benefit of chemotherapy for thymic carcinoma is controversial, cisplatin-based chemotherapy with or without radiation therapy is ordinarily adopted in advanced cases. We evaluated the clinical outcome of platinum-based chemotherapy with or without radiation therapy in unresectable thymic carcinoma patients. Ten patients with unresectable thymic carcinoma were treated with platinum-based chemotherapy with or without radiation therapy in the National Cancer Center Hospital between 1989 and 1998. We reviewed the histological type, treatment, response and survival of these patients. Four of the 10 patients responded to chemotherapy and both the median progression-free survival period and the median response duration were 6.0 months. The median survival time was 11.0 months. There was no relationship between histological classification and prognosis. Platinum-based chemotherapy with or without thoracic radiation is, regardless of tumor histology, marginally effective in advanced thymic carcinoma patients, giving only a modest tumor response rate and short response duration and survival. (author)

  15. Melatonin as Protection Against Radiation Injury

    DEFF Research Database (Denmark)

    Zetner, D.; Andersen, L. P H; Rosenberg, J.

    2016-01-01

    Introduction: Radiation is widely used in the treatment of various cancers and in radiological imaging procedures. Ionizing radiation causes adverse effects, leading to decreased quality of life in patients, by releasing free radicals that cause oxidative stress and tissue damage. The sleep......-hormone melatonin is a free radical scavenger, and induces several anti-oxidative enzymes. This review investigates the scientific literature on the protective effects of melatonin against exposure to ionizing radiation, and discusses the clinical potential of melatonin as prophylactic treatment against ionizing...... and protected against radiation enteritis. These protective effects were only documented when melatonin was administered prior to exposure to ionizing radiation. Discussion: This review documents that melatonin effectively protects animals against injury to healthy tissues from ionizing radiation. However...

  16. Dietary flaxseed administered post thoracic radiation treatment improves survival and mitigates radiation-induced pneumonopathy in mice

    International Nuclear Information System (INIS)

    Christofidou-Solomidou, Melpo; Cengel, Keith A; Tyagi, Sonia; Tan, Kay-See; Hagan, Sarah; Pietrofesa, Ralph; Dukes, Floyd; Arguiri, Evguenia; Heitjan, Daniel F; Solomides, Charalambos C

    2011-01-01

    Flaxseed (FS) is a dietary supplement known for its antioxidant and anti-inflammatory properties. Radiation exposure of lung tissues occurs either when given therapeutically to treat intrathoracic malignancies or incidentally, such as in the case of exposure from inhaled radioisotopes released after the detonation of a radiological dispersion devise (RDD). Such exposure is associated with pulmonary inflammation, oxidative tissue damage and irreversible lung fibrosis. We previously reported that dietary FS prevents pneumonopathy in a rodent model of thoracic X-ray radiation therapy (XRT). However, flaxseed's therapeutic usefulness in mitigating radiation effects post-exposure has never been evaluated. We evaluated the effects of a 10%FS or isocaloric control diet given to mice (C57/BL6) in 2 separate experiments (n = 15-25 mice/group) on 0, 2, 4, 6 weeks post a single dose 13.5 Gy thoracic XRT and compared it to an established radiation-protective diet given preventively, starting at 3 weeks prior to XRT. Lungs were evaluated four months post-XRT for blood oxygenation levels, inflammation and fibrosis. Irradiated mice fed a 0%FS diet had a 4-month survival rate of 40% as compared to 70-88% survival in irradiated FS-fed mouse groups. Additionally, all irradiated FS-fed mice had decreased fibrosis compared to those fed 0%FS. Lung OH-Proline content ranged from 96.5 ± 7.1 to 110.2 ± 7.7 μg/ml (Mean ± SEM) in all irradiated FS-fed mouse groups, as compared to 138 ± 10.8 μg/ml for mice on 0%FS. Concomitantly, bronchoalveolar lavage (BAL) protein and weight loss associated with radiation cachexia was significantly decreased in all FS-fed groups. Inflammatory cell influx to lungs also decreased significantly except when FS diet was delayed by 4 and 6 weeks post XRT. All FS-fed mice (irradiated or not), maintained a higher blood oxygenation level as compared to mice on 0%FS. Similarly, multiplex cytokine analysis in the BAL fluid revealed a significant decrease

  17. Dietary flaxseed administered post thoracic radiation treatment improves survival and mitigates radiation-induced pneumonopathy in mice

    Directory of Open Access Journals (Sweden)

    Arguiri Evguenia

    2011-06-01

    Full Text Available Abstract Background Flaxseed (FS is a dietary supplement known for its antioxidant and anti-inflammatory properties. Radiation exposure of lung tissues occurs either when given therapeutically to treat intrathoracic malignancies or incidentally, such as in the case of exposure from inhaled radioisotopes released after the detonation of a radiological dispersion devise (RDD. Such exposure is associated with pulmonary inflammation, oxidative tissue damage and irreversible lung fibrosis. We previously reported that dietary FS prevents pneumonopathy in a rodent model of thoracic X-ray radiation therapy (XRT. However, flaxseed's therapeutic usefulness in mitigating radiation effects post-exposure has never been evaluated. Methods We evaluated the effects of a 10%FS or isocaloric control diet given to mice (C57/BL6 in 2 separate experiments (n = 15-25 mice/group on 0, 2, 4, 6 weeks post a single dose 13.5 Gy thoracic XRT and compared it to an established radiation-protective diet given preventively, starting at 3 weeks prior to XRT. Lungs were evaluated four months post-XRT for blood oxygenation levels, inflammation and fibrosis. Results Irradiated mice fed a 0%FS diet had a 4-month survival rate of 40% as compared to 70-88% survival in irradiated FS-fed mouse groups. Additionally, all irradiated FS-fed mice had decreased fibrosis compared to those fed 0%FS. Lung OH-Proline content ranged from 96.5 ± 7.1 to 110.2 ± 7.7 μg/ml (Mean ± SEM in all irradiated FS-fed mouse groups, as compared to 138 ± 10.8 μg/ml for mice on 0%FS. Concomitantly, bronchoalveolar lavage (BAL protein and weight loss associated with radiation cachexia was significantly decreased in all FS-fed groups. Inflammatory cell influx to lungs also decreased significantly except when FS diet was delayed by 4 and 6 weeks post XRT. All FS-fed mice (irradiated or not, maintained a higher blood oxygenation level as compared to mice on 0%FS. Similarly, multiplex cytokine analysis in the

  18. Dietary flaxseed administered post thoracic radiation treatment improves survival and mitigates radiation-induced pneumonopathy in mice

    Energy Technology Data Exchange (ETDEWEB)

    Christofidou-Solomidou, Melpo [Department of Medicine, Pulmonary Allergy and Critical Care Division, University of Pennsylvania Medical Center, Philadelphia, PA 19104 (United States); Cengel, Keith A [Radiation Oncology, University of Pennsylvania Medical Center, Philadelphia, PA 19104 (United States); Tyagi, Sonia [Department of Medicine, Pulmonary Allergy and Critical Care Division, University of Pennsylvania Medical Center, Philadelphia, PA 19104 (United States); Tan, Kay-See [Biostatistics & Epidemiology, University of Pennsylvania Medical Center, Philadelphia, PA 19104 (United States); Hagan, Sarah [Radiation Oncology, University of Pennsylvania Medical Center, Philadelphia, PA 19104 (United States); Pietrofesa, Ralph; Dukes, Floyd; Arguiri, Evguenia [Department of Medicine, Pulmonary Allergy and Critical Care Division, University of Pennsylvania Medical Center, Philadelphia, PA 19104 (United States); Heitjan, Daniel F [Biostatistics & Epidemiology, University of Pennsylvania Medical Center, Philadelphia, PA 19104 (United States); Solomides, Charalambos C [Department of Pathology, Jefferson University Hospital, Philadelphia, PA 19140 (United States)

    2011-06-24

    Flaxseed (FS) is a dietary supplement known for its antioxidant and anti-inflammatory properties. Radiation exposure of lung tissues occurs either when given therapeutically to treat intrathoracic malignancies or incidentally, such as in the case of exposure from inhaled radioisotopes released after the detonation of a radiological dispersion devise (RDD). Such exposure is associated with pulmonary inflammation, oxidative tissue damage and irreversible lung fibrosis. We previously reported that dietary FS prevents pneumonopathy in a rodent model of thoracic X-ray radiation therapy (XRT). However, flaxseed's therapeutic usefulness in mitigating radiation effects post-exposure has never been evaluated. We evaluated the effects of a 10%FS or isocaloric control diet given to mice (C57/BL6) in 2 separate experiments (n = 15-25 mice/group) on 0, 2, 4, 6 weeks post a single dose 13.5 Gy thoracic XRT and compared it to an established radiation-protective diet given preventively, starting at 3 weeks prior to XRT. Lungs were evaluated four months post-XRT for blood oxygenation levels, inflammation and fibrosis. Irradiated mice fed a 0%FS diet had a 4-month survival rate of 40% as compared to 70-88% survival in irradiated FS-fed mouse groups. Additionally, all irradiated FS-fed mice had decreased fibrosis compared to those fed 0%FS. Lung OH-Proline content ranged from 96.5 ± 7.1 to 110.2 ± 7.7 μg/ml (Mean ± SEM) in all irradiated FS-fed mouse groups, as compared to 138 ± 10.8 μg/ml for mice on 0%FS. Concomitantly, bronchoalveolar lavage (BAL) protein and weight loss associated with radiation cachexia was significantly decreased in all FS-fed groups. Inflammatory cell influx to lungs also decreased significantly except when FS diet was delayed by 4 and 6 weeks post XRT. All FS-fed mice (irradiated or not), maintained a higher blood oxygenation level as compared to mice on 0%FS. Similarly, multiplex cytokine analysis in the BAL fluid revealed a significant decrease of

  19. Does granulocyte colony-stimulating factor exacerbate radiation-induced acute lung injury in rats?

    International Nuclear Information System (INIS)

    Miura, Gouji; Awaya, Hitomi; Matsumoto, Tsuneo; Tanaka, Nobuyuki; Matsunaga, Naofumi

    2000-01-01

    Radiation pneumonitis (RP) frequently occurs as a complication of thoracic irradiation. However, the mechanism of RP is not well known. Activated neutrophils are a possible pathogenesis of RP. Neutrophil activation induced by granulocyte colony-stimulating factor (G-CSF) may exacerbate RP. We studied the effects of recombinant human G-CSF on acute lung injury induced by thoracic irradiation using rats. Animals were divided into three groups: sham irradiation with saline control, irradiation alone, and irradiation with G-CSF. Actual irradiation was given as a single fraction of 16 Gy delivered to the right hemithorax. G-CSF at a dose of 12 μg/body was administered subcutaneously once a day from 14 to 18 days after actual irradiation. Lung injury was evaluated 21 days after irradiation by bronchoalveolar lavage (BAL) fluid findings and the lung wet/dry weight (W/D) ratio. Neutrophil and lymphocyte counts in BAL fluid and the W/D ratio were significantly increased in the irradiation alone and the irradiation with G-CSF groups compared with those of the sham irradiation+saline control group. However, there was no significant difference observed between the irradiation alone and irradiation with G-CSF groups. In conclusion, this study suggests that postradiation administration of G-CSF does not exacerbate acute lung injury induced by thoracic irradiation in rats. (author)

  20. Does granulocyte colony-stimulating factor exacerbate radiation-induced acute lung injury in rats?

    Energy Technology Data Exchange (ETDEWEB)

    Miura, Gouji; Awaya, Hitomi; Matsumoto, Tsuneo; Tanaka, Nobuyuki; Matsunaga, Naofumi [Yamaguchi Univ., Ube (Japan). School of Medicine

    2000-08-01

    Radiation pneumonitis (RP) frequently occurs as a complication of thoracic irradiation. However, the mechanism of RP is not well known. Activated neutrophils are a possible pathogenesis of RP. Neutrophil activation induced by granulocyte colony-stimulating factor (G-CSF) may exacerbate RP. We studied the effects of recombinant human G-CSF on acute lung injury induced by thoracic irradiation using rats. Animals were divided into three groups: sham irradiation with saline control, irradiation alone, and irradiation with G-CSF. Actual irradiation was given as a single fraction of 16 Gy delivered to the right hemithorax. G-CSF at a dose of 12 {mu}g/body was administered subcutaneously once a day from 14 to 18 days after actual irradiation. Lung injury was evaluated 21 days after irradiation by bronchoalveolar lavage (BAL) fluid findings and the lung wet/dry weight (W/D) ratio. Neutrophil and lymphocyte counts in BAL fluid and the W/D ratio were significantly increased in the irradiation alone and the irradiation with G-CSF groups compared with those of the sham irradiation+saline control group. However, there was no significant difference observed between the irradiation alone and irradiation with G-CSF groups. In conclusion, this study suggests that postradiation administration of G-CSF does not exacerbate acute lung injury induced by thoracic irradiation in rats. (author)

  1. Penetrating abdomino-thoracic injuries: report of four impressive, spectacular and representative cases as well as their challenging surgical management.

    Science.gov (United States)

    Eder, Frank; Meyer, Frank; Huth, Christof; Halloul, Zuhir; Lippert, Hans

    2011-03-01

    Gunshot wounds are rare events in European countries, but stab and impalement injuries occur more frequently and are often spectacular. The aim of the study was to describe several types of penetrating abdomino-thoracic injuries as well as the appropriate surgical interventions, including complex wound management. The representative case series includes four patients with abdomino-thoracic penetrating trauma (two impalements and two stabbings), who were treated in a surgical university hospital (tertiary) centre during a 12-month period. 1. A man was impaled on a steel pipe, which entered the body above the right kidney and behind the liver through the mediastinum via the right thorax, passing the heart and aortic arch up to the left clavicle. The rod was removed via sternotomy and median laparotomy. Only the left subclavian vein required repair. Postoperatively, a residual lesion of the left brachial plexus caused temporary pneumonia. 2. A leg of a collapsing chair drilled into a woman's left foramen obturatorium and exited the body at the right anterior iliac spine. At a regional hospital, the chair leg was removed and the canal caused by gluteal penetration was excised. Exploratory laparotomy revealed peritonitis resulting from a perforated ileum. The injury was repaired with segmental resection and anastomosis. Postoperative right inguinal wound necrosis necessitated excision and vacuum-assisted closure sealing. The patient has residual paresthesia in her left leg resulting from a sacral plexus lesion. 3. During an altercation, a man was stabbed twice in the right thorax. The right pulmonary lobe, the diaphragm, and the liver dome between segment VIII and V were injured. The patient also had a large scalp avulsion at the left and right parietooccipital site and transection of the biceps muscle at the middle third of the right humerus. The chest injuries, approached via right subcostal incision and right anterior thoracotomy were managed with liver packing (two

  2. Radiation hormesis and its potential to manage radiation injuries

    International Nuclear Information System (INIS)

    Bala, Madhu; Mathew, Lazar

    2000-01-01

    The term radiation hormesis explains stimulatory or beneficial effects of low dose radiation exposure, which cannot be predicted by extrapolation of detrimental or lethal effects of high dose radiation exposure. Although beneficial effects of low doses of radiation were observed soon after discovery of x-rays and radioactivity, studies remained inconclusive until recently, due to (i) inadequate statistical planning of experiments conducted in early part of the 20th century; and (ii) poor dose monitoring. Recently (1980s onwards), large scale, systematic epidemiological and experimental studies with a number of diverse systems have demonstrated existence of radiation hormesis beyond doubt. It is pointed out that the hormetic effects of radiation have not been successfully exploited so far for human benefits, primarily because underlying molecular mechanisms are poorly understood. It is argued that with more and more studies, it is becoming evident that radiation hormesis is not merely physiological adaptation, but a genetically regulated phenomenon and involves de novo synthesis of proteins. Role of these proteins in induction of radiation hormesis is the current area of research in a number of world-renowned laboratories. The first part of this review elucidates the shifts in paradigms on radiation effects in the 20th century and the later portion presents a brief on underlying molecular mechanisms of radiation hormesis and their implications towards management of radiation injuries. (author)

  3. Radiation injury to peripheral and cranial nerves

    International Nuclear Information System (INIS)

    Giese, W.L.; Kinsella, T.J.

    1991-01-01

    In this paper, the results of laboratory and clinical investigations regarding the radiosensitivity of peripheral nerve are presented. Before outlining this research the authors briefly review peripheral neuroanatomy and physiology and then discuss variables associated with injury. It is important to remember that radiation injury is multifactorial in nature, and that the relative importance of individual factors is not well understood. Reports up through the middle of this century were fraught with rudimentary dosimetry, primitive investigative methods, and arbitrary endpoints that resulted in widely conflicting conclusions that continue to date

  4. Concomitant Imaging Dose and Cancer Risk in Image Guided Thoracic Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yibao; Wu, Hao [Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing (China); Chen, Zhe [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Knisely, Jonathan P.S. [Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York (United States); Nath, Ravinder [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Feng, Zhongsu [Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing (China); Bao, Shanglian [Beijing Key Laboratory of Medical Physics and Engineering, Peking University, Beijing (China); Deng, Jun, E-mail: jun.deng@yale.edu [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States)

    2015-11-01

    Purpose: Kilovoltage cone beam computed tomography (CT) (kVCBCT) imaging guidance improves the accuracy of radiation therapy but imposes an extra radiation dose to cancer patients. This study aimed to investigate concomitant imaging dose and associated cancer risk in image guided thoracic radiation therapy. Methods and Materials: The planning CT images and structure sets of 72 patients were converted to CT phantoms whose chest circumferences (C{sub chest}) were calculated retrospectively. A low-dose thorax protocol on a Varian kVCBCT scanner was simulated by a validated Monte Carlo code. Computed doses to organs and cardiac substructures (for 5 selected patients of various dimensions) were regressed as empirical functions of C{sub chest}, and associated cancer risk was calculated using the published models. The exposures to nonthoracic organs in children were also investigated. Results: The structural mean doses decreased monotonically with increasing C{sub chest}. For all 72 patients, the median doses to the heart, spinal cord, breasts, lungs, and involved chest were 1.68, 1.33, 1.64, 1.62, and 1.58 cGy/scan, respectively. Nonthoracic organs in children received 0.6 to 2.8 cGy/scan if they were directly irradiated. The mean doses to the descending aorta (1.43 ± 0.68 cGy), left atrium (1.55 ± 0.75 cGy), left ventricle (1.68 ± 0.81 cGy), and right ventricle (1.85 ± 0.84 cGy) were significantly different (P<.05) from the heart mean dose (1.73 ± 0.82 cGy). The blade shielding alleviated the exposure to nonthoracic organs in children by an order of magnitude. Conclusions: As functions of patient size, a series of models for personalized estimation of kVCBCT doses to thoracic organs and cardiac substructures have been proposed. Pediatric patients received much higher doses than did the adults, and some nonthoracic organs could be irradiated unexpectedly by the default scanning protocol. Increased cancer risks and disease adverse events in the

  5. Chemotherapy of radiation injuries: research perspectives

    International Nuclear Information System (INIS)

    Mynchev, N.

    1993-01-01

    The therapy of radiation injuries - single and combined with other physical trauma (burn or wound) - are considered. Anti-bacterial therapy of infections in irradiated mice, rats and dogs and in irradiated dogs inflicted with burns has been applied. The results demonstrate that radiation induced exogenous and endogenous infections can be treated successfully with proper antimicrobial agents. Some immunomodulators also are effective in treating endogenous infection. The synergy between antimicrobial and immuno-modulator therapy holds promise for increasing the survival of irradiated victims. The improvement of managing infections in immuno-compromised (irradiated and injured) hosts will require further research using these therapeutic modalities. (author)

  6. Impact direction effect on serious-to-fatal injuries among drivers in near-side collisions according to impact location: focus on thoracic injuries.

    Science.gov (United States)

    Lai, Xinghua; Ma, Chunsheng; Hu, Jingwen; Zhou, Qing

    2012-09-01

    Occupant injury in real world vehicle accidents can be significantly affected by a set of crash characteristics, of which impact direction and impact location (or damage location) in general scale interval (e.g., frontal impact is frequently defined as general damage to vehicle frontal end with impact angle range of 11-1 o'clock) have been identified to associate with injury outcome. The effects of crash configuration in more specific scale of interval on the injury characteristics have not been adequately investigated. This paper presents a statistical analysis to investigate the combined effects of specific impact directions and impact locations on the serious-to-fatal injuries of driver occupants involved in near-side collisions using crash data from National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) for the calendar years of 1995-2005. The screened injury dataset is categorized by three impact locations (side front, side center and side distributed) and two impact directions (oblique impact at 10 o'clock and pure lateral impact at 9 o'clock), resulting in six crash configurations in total. The weighted counts and the risks of different types of injuries in each subgroup are calculated, with which the relative risks along with 95% confidence intervals under oblique impacts versus lateral impacts in each impact location category are computed. Accordingly, the most frequent injury patterns, the risks and the coded-sources of serious thoracic injuries in different crash configurations are identified. The approach adopted in the present study provides new perspectives into occupant injury outcomes and associated mechanism. Results of the analyses reveal the importance of consideration of the crash configurations beyond the scope of existing side-impact regulatory tests and stress the necessity of vehicle crashworthiness and restraint system design in omni-direction to better protect occupants in real-world crash scenarios. Copyright © 2012

  7. Regulatory limits in radiation injury cases

    International Nuclear Information System (INIS)

    Charnoff, G.

    1980-01-01

    Recent developments in the application of the principles of tort, and the impact of governmental regulations on tort law in the U.S.A. are summarised in relation to the following 1979 events raising the issue of liability for radiation injuries: Three Mile Island accident, the Karen Silkwood trial, nuclear weapons testing exposure cases, the use of uranium tailings in residential construction, and radon gas collected in old copper mines. (U.K.)

  8. Radiation-induced brain injury: A review

    Directory of Open Access Journals (Sweden)

    Michael eRobbins

    2012-07-01

    Full Text Available Approximately 100,000 primary and metastatic brain tumor patients/year in the US survive long enough (> 6 months to experience radiation-induced brain injury. Prior to 1970, the human brain was thought to be highly radioresistant; the acute CNS syndrome occurs after single doses > 30 Gy; white matter necrosis occurs at fractionated doses > 60 Gy. Although white matter necrosis is uncommon with modern techniques, functional deficits, including progressive impairments in memory, attention, and executive function have become important, because they have profound effects on quality of life. Preclinical studies have provided valuable insights into the pathogenesis of radiation-induced cognitive impairment. Given its central role in memory and neurogenesis, the majority of these studies have focused on the hippocampus. Irradiating pediatric and young adult rodent brains leads to several hippocampal changes including neuroinflammation and a marked reduction in neurogenesis. These data have been interpreted to suggest that shielding the hippocampus will prevent clinical radiation-induced cognitive impairment. However, this interpretation may be overly simplistic. Studies using older rodents, that more closely match the adult human brain tumor population, indicate that, unlike pediatric and young adult rats, older rats fail to show a radiation-induced decrease in neurogenesis or a loss of mature neurons. Nevertheless, older rats still exhibit cognitive impairment. This occurs in the absence of demyelination and/or white matter necrosis similar to what is observed clinically, suggesting that more subtle molecular, cellular and/or microanatomic modifications are involved in this radiation-induced brain injury. Given that radiation-induced cognitive impairment likely reflects damage to both hippocampal- and non-hippocampal-dependent domains, there is a critical need to investigate the microanatomic and functional effects of radiation in various brain

  9. Reduced radiation exposure to the mammary glands in thoracic computed tomography using organ-based tube-current modulation

    International Nuclear Information System (INIS)

    Munechika, Jiro; Ohgiya, Yoshimitsu; Gokan, Takehiko; Hashimoto, Toshi; Iwai, Tsugunori

    2013-01-01

    Organ-based tube-current modulation has been used to reduce radiation exposure to specific organs. However, there are no reports yet published on reducing radiation exposure in clinical cases. In this study, we assessed the reduction in radiation exposure to the mammary glands during thoracic computed tomography (CT) using X-CARE. In a phantom experiment, the use of X-CARE reduced radiation exposure at the midline of the precordial region by a maximum of 45.1%. In our corresponding clinical study, CT was performed using X-CARE in 15 patients, and without X-CARE in another 15. Compared to the non-X-CARE group, radiation exposure was reduced in the X-CARE group at the midline of the precordial region by 22.3% (P 0.05). X-CARE thus reduced radiation exposure at the midline of the precordial region and allowed us to obtain consistent CT values without increasing noise. However, this study revealed increases in radiation exposure at the lateral sides of the breasts. It is conceivable that patients' breasts were laterally displaced by gravity under the standard thoracic imaging conditions. Further studies that consider factors such as body size and adjustment of imaging conditions may be needed in the future. (author)

  10. Hematological parameters after acute radiation injury

    International Nuclear Information System (INIS)

    Hirashima, Kunitake

    1989-01-01

    According to clinical experiences of radiation accidents during the past two decades, utilization of measured hematologic changes as a direcrt indicator of the severity of radiation injury provides important information for diagnosis and prognostic evaluation in individual cases. Hematologic changes can be described in terms of prognostic categories based on the possible outcome of the acute radiation syndrome. The five categories suggested by Wald according to the grade of severity. By the actual application of this category to our experience of the 1971 Chiba accident of exposure to irridium 192, it was proved that the estimated dose was well correlated to the value by cytogenetic analysis and physical estimation used of thermo-luminescence phenomena. In hematological parameters, a decrease of lymphocytes occurs whithin 24 hours after the exposure. The level of this early lymphopenia is regarded as one of the best indicators of severity of radiation injury. For the decision of therapeutic procedures, however, the total granulocyte count and platelet count are more valuable to exclude severe infection and bleeding symptoms occurred one month after the exposure. The limitation of the approach by hematologic data must exist in the case exposed in a non-uniform fashion. To overwhelm this difficulty, the application of rapid marrow scanning by short-lived RI such as 52 Fe is expected and the bone marrow imaging by magnetic resonance studies is more exciting. For more sensitive and technically easy-drived methods detecting hematologic injury, our new method of detecting micro-nucleus in polychromatic erythroblasts from cultured erythroid colonies from peripheral blood is now developing. Preliminary data have shown the sensitivity of this method is comparable to the cytogenetic study of pheripheral lymphocytes. (author)

  11. Patterns of failure after complete resection of thoracic esophageal squamous cell carcinoma: implications for postoperative radiation therapy volumes

    International Nuclear Information System (INIS)

    Zhang Wencheng; Wang Qifeng; Xiao Zefen; Yang Longhai; Liu Xiangyang

    2012-01-01

    Objective: To analyze intrathoracic or extrathoracic recurrence pattern after surgical resection of thoracic esophageal squamous cell carcinoma (TESCC) and its help for further modify and improvement on the target of postoperative radiation therapy. Methods: One hundred and ninety-five patients who had undergone resection of TESCC at the Cancer Hospital, Chinese Academy of Medical Sciences enrolled from April 1999 to July 2007. Sites of failure on different primary location of esophageal cancer were documented. Results: Patients with upper or middle thoracic esophageal cancer had higher proportion of intrathoracic recurrence. Patients with lower thoracic esophageal cancer had more intrathoracic recurrence and abdominal lymph node metastatic recurrence. Histological lymph node status has nothing to do with intrathoracic recurrence, supraclavicular lymph node (SLN) metastasis or distant metastasis (χ 2 =1.58, 0.06, 0.04, P =0.134, 0.467, 0.489, respectively), whereas the chance of abdominal lymph node metastases in N positive patients was significantly higher than that in N 0 patients (28.7%: 10.6%, χ 2 =9.94, P =0.001), and so did in middle thoracic esophageal cancer (20.0%: 5.6%, χ 2 =5.67, P =0.015). Anatomic recurrence rate of patients with proximal resection margin no more than 3 cm was significantly higher compared to those more than 3 cm (25.0%: 11.3%, χ 2 =5.65, P=0.019). Conclusions: Mediastinum is the most common recurrence site.According to recurrence site, the following radiation targets are recommended: when tumor was located at the upper or middle thoracic esophagus with negative N status, the mediastinum, the tumor bed and the supraclavicular region should be included as postoperative RT target; when tumor was located at the middle thoracic esophagus with positive N or located at the lower thoracic esophagus, the abdominal lymph node should be added.If the proximal resection margin was no more than 3 cm, the anastomotic-stoma should be included

  12. Repeated radiation injuries by fission products

    International Nuclear Information System (INIS)

    Vasilenko, I.Ya.

    1986-01-01

    Attention is given to repeated radiation injuries during internal irradiation of theoretical and practical interest, particularly in case of the intake into organism of young products of nuclear fission (PNF). The results of experiments with dogs with repeated radioactive iodine injury the isotopes of which (131-135sub(I)) constitute a considerable part of PNF activity are discussed. The blood reaction and protein metabolism state have been studied. Observations for dogs have been continued for about 4 years. The doses for thyroid, gastrointestinal tract and liver subjected to the most intensive irradiation consituted in the first series of experiments after the first intake about 3;0.3;0.05 Gy, after the second - 5;0.5;0.08 Gy and in the second series of experiments - 3;0.3;0.05 Gy and 0.6;0.06;0.01 Gy, respectively. Hematologic factors,thyroid function, changes in exchange and immunologic reactivity have been studied. The dogs have been under observation for 5 years. It is shown in case of repeated intake of Isup(131) PNF into animals organism in quantity which does not cause during the acute period a clinically outlined sickness, substantial differences in the organism reaction as compared with the first intake of radionuclides have not been found. The presence of residual radiation injuries did not cause charging action during the acute period during PNF and repeated intake which in the author's opinion testifies to perfection of compensator mechanisms in case of intake of such quantities of radioactive products. At the remote periods blastomogenic action manifested which is estimated as a result of general biological action of radionuclides administered to the organism. The necessity in subsequent investigations for obtaining the data on organism reactivity, clinic and pathogenesis with the aim of prophylaxis and treatment of such injuries is indicated

  13. Combined therapy of urinary bladder radiation injury

    International Nuclear Information System (INIS)

    Zaderin, V.P.; Polyanichko, M.F.

    1982-01-01

    A scheme of therapy of radiation cystitis is suggested. It was developed on the basis of evaluation of literature data and clinical of 205 patients with radiation injury of the urinary bladder. The method is based on general and local therapy of damaged tissues by antiinflammatory drugs, anesthetics and stimulators of reparative regeneration. Severe ulcerative and incrustation cystites, refractory to conservative therapy, were treated by surgery, using antiseptics and reparation stimulators before, during and after operation. As a result, there were hardly any complications after reconstruction of the bladder with intestinal and peritoneal tissues. 104 patients (96.1%) were cured completely and ability to work was restored in 70 patients (76.9%) [ru

  14. Diagnosis and treatment of radiation injuries

    International Nuclear Information System (INIS)

    1998-01-01

    This publication is directed at medical professionals who may be involved in the management of radiation injuries starting from the first few hours or days after an exposure of undefined severity (i.e. those handling the emergency situation may not know the extent and severity of the accident). Experience has shown that in addition to occupational physicians, the complete management of an emergency case involves other professionals such as haematologists, oncologists, plastic surgeons, dermatologists, vascular surgeons, psychiatrists and consultants in other medical specialities. The principal aim of this publication is to provide guidelines to enable medical professionals to carry out prompt diagnostic measures and to offer emergency treatment. This report provides information in tabulated form on clinical criteria for dose assessment. Additionally, it discusses the appropriate dose-effect relationship in cases of external radiation involving either total body or local exposures, as well as internal contamination

  15. Radiation-induced brain injury: A review

    Energy Technology Data Exchange (ETDEWEB)

    Greene-Schloesser, Dana; Robbins, Mike E.; Peiffer, Ann M.; Shaw, Edward G. [Department of Radiation Oncology, Wake Forest School of Medicine,, Winston-Salem, NC (United States); Brain Tumor Center of Excellence, Wake Forest School of Medicine,, Winston-Salem, NC (United States); Wheeler, Kenneth T. [Brain Tumor Center of Excellence, Wake Forest School of Medicine,, Winston-Salem, NC (United States); Department of Radiology, Wake Forest School of Medicine,, Winston-Salem, NC (United States); Chan, Michael D., E-mail: mrobbins@wakehealth.edu [Department of Radiation Oncology, Wake Forest School of Medicine,, Winston-Salem, NC (United States); Brain Tumor Center of Excellence, Wake Forest School of Medicine,, Winston-Salem, NC (United States)

    2012-07-19

    Approximately 100,000 primary and metastatic brain tumor patients/year in the US survive long enough (>6 months) to experience radiation-induced brain injury. Prior to 1970, the human brain was thought to be highly radioresistant; the acute CNS syndrome occurs after single doses >30 Gy; white matter necrosis occurs at fractionated doses >60 Gy. Although white matter necrosis is uncommon with modern techniques, functional deficits, including progressive impairments in memory, attention, and executive function have become important, because they have profound effects on quality of life. Preclinical studies have provided valuable insights into the pathogenesis of radiation-induced cognitive impairment. Given its central role in memory and neurogenesis, the majority of these studies have focused on the hippocampus. Irradiating pediatric and young adult rodent brains leads to several hippocampal changes including neuroinflammation and a marked reduction in neurogenesis. These data have been interpreted to suggest that shielding the hippocampus will prevent clinical radiation-induced cognitive impairment. However, this interpretation may be overly simplistic. Studies using older rodents, that more closely match the adult human brain tumor population, indicate that, unlike pediatric and young adult rats, older rats fail to show a radiation-induced decrease in neurogenesis or a loss of mature neurons. Nevertheless, older rats still exhibit cognitive impairment. This occurs in the absence of demyelination and/or white matter necrosis similar to what is observed clinically, suggesting that more subtle molecular, cellular and/or microanatomic modifications are involved in this radiation-induced brain injury. Given that radiation-induced cognitive impairment likely reflects damage to both hippocampal- and non-hippocampal-dependent domains, there is a critical need to investigate the microanatomic and functional effects of radiation in various brain regions as well as their

  16. Radiation-induced brain injury: A review

    International Nuclear Information System (INIS)

    Greene-Schloesser, Dana; Robbins, Mike E.; Peiffer, Ann M.; Shaw, Edward G.; Wheeler, Kenneth T.; Chan, Michael D.

    2012-01-01

    Approximately 100,000 primary and metastatic brain tumor patients/year in the US survive long enough (>6 months) to experience radiation-induced brain injury. Prior to 1970, the human brain was thought to be highly radioresistant; the acute CNS syndrome occurs after single doses >30 Gy; white matter necrosis occurs at fractionated doses >60 Gy. Although white matter necrosis is uncommon with modern techniques, functional deficits, including progressive impairments in memory, attention, and executive function have become important, because they have profound effects on quality of life. Preclinical studies have provided valuable insights into the pathogenesis of radiation-induced cognitive impairment. Given its central role in memory and neurogenesis, the majority of these studies have focused on the hippocampus. Irradiating pediatric and young adult rodent brains leads to several hippocampal changes including neuroinflammation and a marked reduction in neurogenesis. These data have been interpreted to suggest that shielding the hippocampus will prevent clinical radiation-induced cognitive impairment. However, this interpretation may be overly simplistic. Studies using older rodents, that more closely match the adult human brain tumor population, indicate that, unlike pediatric and young adult rats, older rats fail to show a radiation-induced decrease in neurogenesis or a loss of mature neurons. Nevertheless, older rats still exhibit cognitive impairment. This occurs in the absence of demyelination and/or white matter necrosis similar to what is observed clinically, suggesting that more subtle molecular, cellular and/or microanatomic modifications are involved in this radiation-induced brain injury. Given that radiation-induced cognitive impairment likely reflects damage to both hippocampal- and non-hippocampal-dependent domains, there is a critical need to investigate the microanatomic and functional effects of radiation in various brain regions as well as their

  17. Thoracic spine pain

    Directory of Open Access Journals (Sweden)

    Aleksey Ivanovich Isaikin

    2013-01-01

    Full Text Available Thoracic spine pain, or thoracalgia, is one of the common reasons for seeking for medical advice. The epidemiology and semiotics of pain in the thoracic spine unlike in those in the cervical and lumbar spine have not been inadequately studied. The causes of thoracic spine pain are varied: diseases of the cardiovascular, gastrointestinal, pulmonary, and renal systems, injuries to the musculoskeletal structures of the cervical and thoracic portions, which require a thorough differential diagnosis. Facet, costotransverse, and costovertebral joint injuries and myofascial syndrome are the most common causes of musculoskeletal (nonspecific pain in the thoracic spine. True radicular pain is rarely encountered. Traditionally, treatment for thoracalgia includes a combination of non-drug and drug therapies. The cyclooxygenase 2 inhibitor meloxicam (movalis may be the drug of choice in the treatment of musculoskeletal pain.

  18. Delayed radiation injury to the brain

    International Nuclear Information System (INIS)

    Takano, Shingo; Yoshii, Yoshihiko; Okazaki, Masao; Nose, Tadao; Aida, Shinsuke

    1989-01-01

    The authors report four cases of delayed radiation injury to the brain. One case was diagnosed histologically, and the other three cases, by means of serial CT scans and clinical symptoms. In all cases, a low-density area was observed 4-15 months after radiotherapy, then the contrast-enhanced area appeared within the low-density area about 4 months later. The enhanced area was distant from the original tumor, but within the field of radiotherapy. In the relationship between CT scans and superimposed dose distributions, the enhanced area and the low-density area were always observed within a zone of more than 80% of the total doses, and, as for the irradiated doses, there was no difference between the two areas. However, a distinct difference between these two areas was noted in the MRI scans and histopathology. The enhanced area was imaged as an area of a high signal by means of Gd-DTPA enhanced T 1 -weighted images in two cases. In the one histologically verified case, the fibrinoid necrosis of the blood vessel and demyelination appeared significantly higher in the enhanced area than in the low-density area. In conclusion, when a low-density area was observed by CT scan within the field of radiotherapy, we also suspected radiation injury and considered steroid or anticoagulant therapy in order to reverse it. However, if an enhanced area appeared within the injured lesion, the area seemed to have become irreversible and surgical therapy might also be needed. (author)

  19. Reduction of radiation injury of fresh agricultural products by saccharide

    International Nuclear Information System (INIS)

    Hayashi, Toru; Todoroki, Setsuko

    1998-01-01

    To establish irradiation technologies as one of alternative technology of methyl bromide fumigation, radiation sensitivities for each kind of fresh agricultural products and reduction of radiation injury were investigated. Fresh vegetables and flowers such as cabbage, sprouts, asparagus, lettuce, chrysanthemum, carnation, rose, etc. were used and irradiated with 750 Gy γ-ray. Flowers received radiation injury were soaked into various kinds of solutions for one night, then they were irradiated with 500 Gy γ-ray. They showed different radiation sensitivities. Cruciferae plant showed radioresistance and Compositae plant radiosensitivity. A keeping quality agent for cut flowers indicated protection effect on radiation injury. (S.Y.)

  20. Reduction of radiation injury of fresh agricultural products by saccharide

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Toru; Todoroki, Setsuko [National Food Research Inst., Tsukuba, Ibaraki (Japan)

    1998-02-01

    To establish irradiation technologies as one of alternative technology of methyl bromide fumigation, radiation sensitivities for each kind of fresh agricultural products and reduction of radiation injury were investigated. Fresh vegetables and flowers such as cabbage, sprouts, asparagus, lettuce, chrysanthemum, carnation, rose, etc. were used and irradiated with 750 Gy {gamma}-ray. Flowers received radiation injury were soaked into various kinds of solutions for one night, then they were irradiated with 500 Gy {gamma}-ray. They showed different radiation sensitivities. Cruciferae plant showed radioresistance and Compositae plant radiosensitivity. A keeping quality agent for cut flowers indicated protection effect on radiation injury. (S.Y.)

  1. Indication for resuscitative thoracotomy in thoracic injuries-Adherence to the ATLS guidelines. A forensic autopsy based evaluation

    DEFF Research Database (Denmark)

    Ohrt-Nissen, S; Colville-Ebeling, B; Kandler, K

    2016-01-01

    of deceased patients with potentially reversible thoracic lesions (PRTL). METHODS: The database at the Department of Forensic Medicine at Copenhagen University was queried for autopsy cases with thoracic lesions indicated by the SNOMED autopsy coding system. Patients were included if thoracic lesions were...

  2. Preventive treatment of combined radiation injuries

    International Nuclear Information System (INIS)

    Boudagov, R.; Uljanova, L.; Makarov, G.

    1996-01-01

    The risk of sepsis development increases when thermal burns and other trauma occur in combination with exposure to radiation. Only surgical correction of the life-threatening state recommends within 48 hours after irradiation. All other arrangements have to carry out when hemopoiesis recovery will complete. However exposed patients with combined injuries (CI) die during the first two or three weeks mainly due to sepsis. Therefore prophylaxis and preventive therapy of infectious complications are need early. Actual difficulties in choice of valid treatment procedure for acute radiation syndrome (ARS) exhibit additional aggravation under CI. The available facts prove decreasing early therapy efficiency for rather high dose exposure and wound trauma occurrence. The own results showed that bacterial polysaccharide pyrogenal, glycopin (synthetic analogue of muramil-dipeptide), thymus preparations (thymozin, thymotropin, thymogen), tuftsin, heterologic human and bovine immunoglobulins did not modify the low values of 30-day survival under CI (irradiation + thermal burn). Single injection of prodigiozan, zymozan and some other yeast polysaccharides in 1 hr after CI resulted at moderate increasing of survival. The main purpose of this study, which bases upon our understanding of CI pathogenesis, was search more effective means for preventive treatment of combined radiation injuries. Two groups of remedies were under study. The first group included so called 'biological response modifiers' (BRM). These agents may increase host defences to infection, macrophage's activity and hemopoietic growth factor's secretion. The second group included antibiotics that should be directed against the potential gram-negative as well as gram-positive pathogens and simultaneously be useful for selective decontamination of gastrointestinal tract. (author)

  3. Expression of Angiotensin II and Aldosterone in Radiation-induced Lung Injury.

    Science.gov (United States)

    Cao, Shuo; Wu, Rong

    2012-12-01

    Radiation-induced lung injury (RILI) is the most common, dose-limiting complication in thoracic malignancy radiotherapy. Considering its negative impact on patients and restrictions to efficacy, the mechanism of RILI was studied. Wistar rats were locally irradiated with a single dose of 0, 16, and 20 Gy to the right half of the lung to establish a lung injury model. Two and six months after irradiation, the right half of the rat lung tissue was removed, and the concentrations of TGF-β1, angiotensin II, and aldosterone were determined via enzyme-linked immunosorbent assay. Statistical differences were observed in the expression levels of angiotensin II and aldosterone between the non-irradiation and irradiation groups. Moreover, the expression level of the angiotensin II-aldosterone system increased with increasing doses, and the difference was still observed as time progressed. Angiotensin II-aldosterone system has an important pathophysiological function in the progression of RILI.

  4. Expression of Angiotensin II and Aldosterone in Radiation-induced Lung Injury

    International Nuclear Information System (INIS)

    Cao, Shuo; Wu, Rong

    2012-01-01

    Radiation-induced lung injury (RILI) is the most common, dose-limiting complication in thoracic malignancy radiotherapy. Considering its negative impact on patients and restrictions to efficacy, the mechanism of RILI was studied. Wistar rats were locally irradiated with a single dose of 0, 16, and 20 Gy to the right half of the lung to establish a lung injury model. Two and six months after irradiation, the right half of the rat lung tissue was removed, and the concentrations of TGF-β1, angiotensin II, and aldosterone were determined via enzyme-linked immunosorbent assay. Statistical differences were observed in the expression levels of angiotensin II and aldosterone between the non-irradiation and irradiation groups. Moreover, the expression level of the angiotensin II-aldosterone system increased with increasing doses, and the difference was still observed as time progressed. Angiotensin II-aldosterone system has an important pathophysiological function in the progression of RILI

  5. Prediction and analysis of human thoracic impact responses and injuries in cadaver impacts using a full human body finite element model.

    Science.gov (United States)

    Ruan, Jesse; El-Jawahri, Raed; Chai, Li; Barbat, Saeed; Prasad, Priya

    2003-10-01

    Human thoracic dynamic responses and injuries associated with frontal impact, side impact, and belt loading were investigated and predicted using a complete human body finite element model for an average adult male. The human body model was developed to study the impact biomechanics of a vehicular occupant. Its geometry was based on the Visible Human Project (National Library of Medicine) and the topographies from human body anatomical texts. The data was then scaled to an average adult male according to available biomechanical data from the literature. The model includes details of the head, neck, ribcage, abdomen, thoracic and lumbar spine, internal organs of the chest and abdomen, pelvis, and the upper and lower extremities. The present study is focused on the dynamic response and injuries of the thorax. The model was validated at various impact speeds by comparing predicted responses with available experimental cadaver data in frontal and side pendulum impacts, as well as belt loading. Model responses were compared with similar individual cadaver tests instead of using cadaver corridors because the large differences between the upper and lower bounds of the corridors may confound the model validation. The validated model was then used to study thorax dynamic responses and injuries in various simulated impact conditions. Parameters that could induce injuries such as force, deflection, and stress were computed from model simulations and were compared with previously proposed thoracic injury criteria to assess injury potential for the thorax. It has been shown that the model exhibited speed sensitive impact characteristics, and the compressibility of the internal organs significantly influenced the overall impact response in the simulated impact conditions. This study demonstrates that the development of a validated FE human body model could be useful for injury assessment in various cadaveric impacts reported in the literature. Internal organ injuries, which are

  6. Guiding Device for Precision Grafting of Peripheral Nerves in Complete Thoracic Spinal Cord Injury: Design and Sizing for Clinical Trial

    Directory of Open Access Journals (Sweden)

    Arvid Frostell

    2018-05-01

    Full Text Available BackgroundIn an effort to translate preclinical success in achieving spinal cord regeneration through peripheral nerve grafts, this study details the design and sizing of a guiding device for precision grafting of peripheral nerves for use in a clinical trial in complete (AIS-A thoracic spinal cord injury (SCI. The device’s design and sizing are compared to a simulation of human spinal cord sizes based on the best available data.MethodsSpinal cord segmental sizes were generated by computer simulation based on data from a meta-analysis recently published by our group. Thoracic segments T2–T12 were plotted, and seven elliptical shapes were positioned across the center of the distribution of sizes. Geometrical measures of error-of-fit were calculated. CAD modeling was used to create cranial and caudal interfaces for the human spinal cord, aiming to guide descending white matter tracts to gray matter at the caudal end of the device and ascending white matter tracts to gray matter at the cranial end of the device. The interfaces were compared qualitatively to the simulated spinal cord sizes and gray-to-white matter delineations.ResultsThe mean error-of-fit comparing simulated spinal cord segments T2–T12 to the best elliptical shape was 0.41 and 0.36 mm, and the 95th percentile was found at 1.3 and 0.98 mm for transverse and anteroposterior diameter, respectively. A guiding device design was reached for capturing the majority of corticospinal axons at the cranial end of the device and guiding them obliquely to gray matter at the caudal end of the device. Based on qualitative comparison, the vast majority of spinal cord sizes generated indicate an excellent fit to the device’s interfaces.ConclusionA set of SCI guiding devices of seven sizes can cover the variability of human thoracic spinal cord segments T2–T12 with an acceptable error-of-fit for the elliptical shape as well as guiding channels. The computational framework developed can

  7. Microneurolysis and decompression of long thoracic nerve injury are effective in reversing scapular winging: Long-term results in 50 cases

    Directory of Open Access Journals (Sweden)

    Lyons Andrew B

    2007-03-01

    Full Text Available Abstract Background Long thoracic nerve injury leading to scapular winging is common, often caused by closed trauma through compression, stretching, traction, direct extrinsic force, penetrating injury, or neuritides such as Parsonage-Turner syndrome. We undertook the largest series of long thoracic nerve decompression and neurolysis yet reported to demonstrate the usefulness of long thoracic nerve decompression. Methods Winging was bilateral in 3 of the 47 patients (26 male, 21 female, yielding a total of 50 procedures. The mean age of the patients was 33.4 years, ranging from 24–57. Causation included heavy weight-lifting (31 patients, repetitive throwing (5 patients, deep massage (2 patients, repetitive overhead movement (1 patient, direct trauma (1 patient, motor bike accident (1 patient, and idiopathic causes (9 patients. Decompression and microneurolysis of the long thoracic nerve were performed in the supraclavicular space. Follow-up (average of 25.7 months consisted of physical examination and phone conversations. The degree of winging was measured by the operating surgeon (RKN. Patients also answered questions covering 11 quality-of-life facets spanning four domains of the World Health Organization Quality of Life questionnaire. Results Thoracic nerve decompression and neurolysis improved scapular winging in 49 (98% of the 50 cases, producing "good" or "excellent" results in 46 cases (92%. At least some improvement occurred in 98% of cases that were less than 10 years old. Pain reduction through surgery was good or excellent in 43 (86% cases. Shoulder instability affected 21 patients preoperatively and persisted in 5 of these patients after surgery, even in the 5 patients with persistent instability who experienced some relief from the winging itself. Conclusion Surgical decompression and neurolysis of the long thoracic nerve significantly improve scapular winging in appropriate patients, for whom these techniques should be considered

  8. Intravascular ultrasound is a critical tool for accurate endograft sizing in the management of blunt thoracic aortic injury.

    Science.gov (United States)

    Wallace, Gabriel A; Starnes, Benjamin W; Hatsukami, Thomas S; Sobel, Michael; Singh, Niten; Tran, Nam T

    2015-03-01

    Accurate measurement of true aortic luminal diameter (ALD) is critical for endograft sizing in endovascular treatment of blunt thoracic aortic injury (BTAI), but ALD is dynamic and changes with respect to patients' hemodynamic status. This study aimed to characterize how ALD at the time of diagnosis of BTAI compares with ALD at the time of endovascular repair and later at follow-up. This is an Institutional Review Board-approved, single-institution retrospective analysis of prospectively obtained data. Patients were included who presented between July 2007 and December 2012 with computed tomography angiography (CTA)-diagnosed BTAI; who underwent thoracic endovascular aortic repair (TEVAR); and who underwent preoperative CTA, intraoperative intravascular ultrasound (IVUS), and postimplantation CTA. Comparison measurements of the ALD were made among CTA and IVUS images at the level of the left subclavian artery (LSCA) and between initial CTA and postimplantation CTA at 10, 15, and 20 cm distal to the LSCA. Theoretical endograft sizes were determined and compared for each ALD at the LSCA. Twenty-two patients were included in the analysis. Mean age was 38 ± 14 years (range, 17-61 years), with 82% men and mean Injury Severity Score of 43 ± 11 (range, 24-66). Mean time from emergency department admission to initial CTA was -1.2 ± 5 hours (range, -13 to 11.5 hours; negative time implies imaging at an outside facility before admission). Mean time from initial CTA to IVUS was 1.2 ± 1.4 days (range, 2.5 hours-5.7 days) and from IVUS to postimplantation CTA 33 ± 45 days (range, 17 hours-169 days). Overall, ALD measured by IVUS was significantly larger than that by initial CTA (Δ2.5 ± 3.1 mm; P < .05). ALD was also larger at 10, 15, and 20 cm distal to the LSCA in comparing the postimplantation CTA with the initial CTA (Δ2.4, 2.0, and 2.0 mm, respectively; all P < .05). More than half the devices would be sized differently with ALD measured by IVUS at the time of TEVAR

  9. General discussion about enzymes activities of radiation injury

    International Nuclear Information System (INIS)

    Vucicevic, M.; Sukalo, I.

    1989-01-01

    Researching reliable and practical indicators of radiation injury, however, is very interesting and considerable department of scientific studies, practical and theoretical. Enzymes activities are among biochemical indicators which are changed after radiation injury. Activity of these specific proteins is important in regulation of every biochemical reaction in existing beings. Biological macromolecules can be damaged by radiation or the cell permeability can be changed. All of these influence directly on enzymes activities. In this paper we present the review of the all important enzymes, indicators of the radiation injury, which variances on reference to normal values are significant of the functional and the structural changes of essential organs (author)

  10. General discussion about enzymes activities of radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Vucicevic, M; Sukalo, I [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1989-07-01

    Researching reliable and practical indicators of radiation injury, however, is very interesting and considerable department of scientific studies, practical and theoretical. Enzymes activities are among biochemical indicators which are changed after radiation injury. Activity of these specific proteins is important in regulation of every biochemical reaction in existing beings. Biological macromolecules can be damaged by radiation or the cell permeability can be changed. All of these influence directly on enzymes activities. In this paper we present the review of the all important enzymes, indicators of the radiation injury, which variances on reference to normal values are significant of the functional and the structural changes of essential organs (author)

  11. Integrative Metabolic Signatures for Hepatic Radiation Injury.

    Directory of Open Access Journals (Sweden)

    Irwin Jack Kurland

    Full Text Available Radiation-induced liver disease (RILD is a dose-limiting factor in curative radiation therapy (RT for liver cancers, making early detection of radiation-associated liver injury absolutely essential for medical intervention. A metabolomic approach was used to determine metabolic signatures that could serve as biomarkers for early detection of RILD in mice.Anesthetized C57BL/6 mice received 0, 10 or 50 Gy Whole Liver Irradiation (WLI and were contrasted to mice, which received 10 Gy whole body irradiation (WBI. Liver and plasma samples were collected at 24 hours after irradiation. The samples were processed using Gas Chromatography/Mass Spectrometry and Liquid Chromatography/Mass Spectrometry.Twenty four hours after WLI, 407 metabolites were detected in liver samples while 347 metabolites were detected in plasma. Plasma metabolites associated with 50 Gy WLI included several amino acids, purine and pyrimidine metabolites, microbial metabolites, and most prominently bradykinin and 3-indoxyl-sulfate. Liver metabolites associated with 50 Gy WLI included pentose phosphate, purine, and pyrimidine metabolites in liver. Plasma biomarkers in common between WLI and WBI were enriched in microbial metabolites such as 3 indoxyl sulfate, indole-3-lactic acid, phenyllactic acid, pipecolic acid, hippuric acid, and markers of DNA damage such as 2-deoxyuridine. Metabolites associated with tryptophan and indoles may reflect radiation-induced gut microbiome effects. Predominant liver biomarkers in common between WBI and WLI were amino acids, sugars, TCA metabolites (fumarate, fatty acids (lineolate, n-hexadecanoic acid and DNA damage markers (uridine.We identified a set of metabolomic markers that may prove useful as plasma biomarkers of RILD and WBI. Pathway analysis also suggested that the unique metabolic changes observed after liver irradiation was an integrative response of the intestine, liver and kidney.

  12. Radiation Therapy of a Chordoma of the Thoracic Vertebra-a Case Report and Review of Literatures-

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Joo Young; Choi, Myung Sun [Korea University College of Medicine, Seoul (Korea, Republic of)

    1988-12-15

    Chordom is a malignant tumor arising from the primitive notochord involving the axial skeleton. It usually occurs at sacrococcygeal and basisphenoidal area but only rarely does at other vertebral areas, especially at the thoracic vertebrae. It has a slow growth rate and is locally aggressive with an extremely high rate of local recurrence. Either surgery or radiation alone often fails to cure the disease and the local failure is the main cause of treatment failure and death. Overall 5 year survival rate is less than 10%. Useful palliation or occasional cure can be obtained by the combination of surgery and radiotherapy. After incomplete resection, the tumor requires radiation dose of 7,000 cGy or more over 6-7 weeks for local control. Tumor regression is slow in response to irradiation and continuation of the regression for several months after completion of RT is not unusual. We report a case of chordoma of the thoracic vertebra, the site of extreme rarity, which showed good local control after partial resection and radiation therapy. He is well and alive without any evidence of recurrence after 13 months of treatment with near complete tumor regression.

  13. Radiation Therapy of a Chordoma of the Thoracic Vertebra-a Case Report and Review of Literatures-

    International Nuclear Information System (INIS)

    Kim, Joo Young; Choi, Myung Sun

    1988-01-01

    Chordom is a malignant tumor arising from the primitive notochord involving the axial skeleton. It usually occurs at sacrococcygeal and basisphenoidal area but only rarely does at other vertebral areas, especially at the thoracic vertebrae. It has a slow growth rate and is locally aggressive with an extremely high rate of local recurrence. Either surgery or radiation alone often fails to cure the disease and the local failure is the main cause of treatment failure and death. Overall 5 year survival rate is less than 10%. Useful palliation or occasional cure can be obtained by the combination of surgery and radiotherapy. After incomplete resection, the tumor requires radiation dose of 7,000 cGy or more over 6-7 weeks for local control. Tumor regression is slow in response to irradiation and continuation of the regression for several months after completion of RT is not unusual. We report a case of chordoma of the thoracic vertebra, the site of extreme rarity, which showed good local control after partial resection and radiation therapy. He is well and alive without any evidence of recurrence after 13 months of treatment with near complete tumor regression

  14. Medical treatment of radiation injuries-Current US status

    Energy Technology Data Exchange (ETDEWEB)

    Jarrett, D.G. [OSA - CBD and CDP, 3050 Defense Pentagon, Room 3C257, Washington, DC 20301-3050 (United States)], E-mail: david.jarrett@us.army.mil; Sedlak, R.G.; Dickerson, W.E. [Uniformed Services University, Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States); Reeves, G.I. [Northrop Grumman IT, 8211 Terminal Road, Lorton, VA 22079-1421 (United States)

    2007-07-15

    A nuclear incident or major release of radioactive materials likely would result in vast numbers of patients, many of whom would require novel therapy. Fortunately, the numbers of radiation victims in the United States (USA) have been limited to date. If a mass-casualty situation occurs, there will be a need to perform rapid, accurate dose estimates and to provide appropriate medications and other treatment to ameliorate radiation injury. The medical management of radiation injury is complex. Radiation injury may include acute radiation sickness (ARS) from external and/or internal radiation exposure, internal organ damage from incorporated radioactive isotopes, and cutaneous injury. Human and animal data have shown that optimal medical care may nearly double the survivable dose of ionizing radiation. Current treatment strategies for radiation injuries are discussed with concentration on the medical management of the hematopoietic syndrome. In addition, priority areas for continuing and future research into both acute deterministic injuries and also long-term stochastic sequelae of radiation exposure have been identified. There are several near-term novel therapies that appear to offer excellent prognosis for radiation casualties, and these are also described.

  15. Plastic and reconstructive surgical treatment of the radiation injuries

    International Nuclear Information System (INIS)

    Ono, Nobutaka; Ogo, Ken; Uchiyama, Kanenari; Fukushima, Hisaki

    1977-01-01

    Eleven cases of radiation injury are reported. Three of them were relatively superficial ''radiation dermatitis''. They received radical excision and free skin-grafting to the cosmetic and functional satisfaction. Eight patients had deeper injury, ''radiation ulcer''. Six cases were treated by ''local flap''. The local flap technique is the simplest and the most effective way to treat the radiation ulcer. The reason is 1) it is a one stage operation, 2) it has a permanent pedicle supplying good blood flow, 3) it has very close texture and color match to the area. However, a skin-grafting performed on one patient of radiation ulcer ended up with failure. The indication of the skin-grafting and the local flap was discussed from the point of the stage or degree of radiation injuries and the recommendable method is the skin-grafting to the radiation dermatitis and the local flap to the radiation ulcer. (auth.)

  16. Blunt thoracic trauma and cardiac injury in the athlete: contemporary management.

    Science.gov (United States)

    DE Gregorio, Cesare; Magaudda, Ludovico

    2017-09-29

    Commotion cordis and cardiac injuries are rare events usually following a chest blunt trauma during sports activities. Various aetiologies have been identified to cause electrical (commotion cordis) and/or structural (contusion and further injuries) damage, but high-velocity tools such as baseballs or hockey pucks (also called projectiles) have been chiefly identified. Clinical consequences are challenging, varying from uncomplicated supraventricular arrhythmias to cardiac wall rupture. Ventricular fibrillation is the most remarkable outcome leading to cardiac arrest in some individuals. In this article, up-to-date epidemiological and pathophysiological issues are discussed, along with the most suitable assistance protocols of the injured athlete in the sports arena. Current knowledge about traumatic sports injuries and ensuing cardiovascular sequelae made significant steps forwards than in the past. The majority of athletes (especially the youngest ones) wearing chest protectors are usually preserved from serious outcomes and sudden cardiac death, but further technical effort is encouraged to attain more satisfactory barriers against projectile's impact. Educational campaigns among students, closer team surveillance, implementation of the sports arenas with adequate rescue devices and medical assistance remain mandatory in every sports activity.

  17. Studies on radiation injury of the kidney

    International Nuclear Information System (INIS)

    Kamiya, Akio

    1982-01-01

    According to many experimental reports on the radiation renal injuries, the influences of irradiation were observed not only in the irradiated kidney, but also in the contralateral kidney. However, its mechanism has not yet been demonstrated clearly. In order to clarify the mechanism of development of pathophysiological changes seen on the kidney of non-irradiated side, a study was made of function and pathological condition of a remaining kidney after the enucleation of ir radiated side kidney after irradiation. Twenty-eitht rabbits were divided into 4 groups. A: 14 rabbits were irradiated on their left kidney with 60 Co- gamma ray 50 Gy doses. B: 6 rabbits were nephrectomized of their left kidney on the first day after 50 Gy irradiation. C: 4 rabbits were nephrectomized of their left kidney on the eighth day after 50 Gy irradiation. D: 4 rabbits were simple nephrectomized. The results suggest that changes on the irradiated side of kidney bring about effect to the contra-lateral kidney at an early stage after the irradiation. (J.P.N.)

  18. Radiation injuries in atomic bomb survivors, chapter 2

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Atomic bombs, for the first time in human history, were dropped on Hiroshima in August 6, and on Nagasaki on August 9, 1945. Though the powers of these bombs were small as compared with those of present day nuclear weapons, the atomic bombs claimed many lives instantaneously, damaged human bodies, and destroyed all objects, annihilating the urban areas. Even today, the dreadful consequences of the bombings still remain in both body and mind of the victims. Meanwhile, the experiences of atomic bomb disasters are fading constantly. In order to maintain the vivid information, in Part 2 ''Bodily injuries'', the following matters are described: early bodily injuries such as burns, (blast) external wounds, radiation injuries, and pathology in bodily injuries; later bodily injuries such as keloids, injuries to blood and eyes, injuries in exposed women, injuries in growth, aging and life, injuries in mental/nervous system, malignant tumors, and changes in chromosomes; and genetic effects. (J.P.N.)

  19. Prenatal radiation injury and immune development

    International Nuclear Information System (INIS)

    Nold, J.B.; Miller, G.K.; Benjamin, S.A.

    1985-01-01

    Previous studies demonstrated a significant reduction in thymic medullary and epithelial volumes in irradiated canine fetuses. The present study was performed to determine if this prenatal radiation-induced damage persists and is accompanied by functional immune abnormalities after birth. Six pregnant beagle dogs received sham-irradiation or single abdominal exposures to 200R of 60Co radiation at 35 days gestation. The mean fetal dose was approximately 1.5 Gy. Half the dogs of each litter were sacrificed at birth; half were sacrificed at 24 weeks of age. Following sacrifice, thymus sections from each dog were examined morphometrically. The following in vitro and in vivo assays were performed at selected times; lymphocyte blastogenesis, hematology, bone marrow progenitor cell (CFU-GM) colony growth, humoral antibody response to sheep red blood cells, dinitrochloro-benzene skin sensitization, and gross and histopathology. When compared with age-matched controls, thymic medullary volumes in irradiated dogs were significantly reduced at birth; but, by 24 weeks of age, were similar to control values. At 12-16 weeks of age irradiated dogs showed a significant decrease in humoral antibody responses to inoculated sheep red blood cells. In vitro culture of bone marrow demonstrated a significant reduction of CFU-GM colony growth in irradiated dogs at 24 weeks of age. This was accompanied by a reduction in peripheral white blood cell counts in these dogs from 12-24 weeks of age. These data suggest that radiation injury to the fetal lymphohematopoietic system results in significant postnatal immunologic and hematopoietic defects

  20. Feasibility of emergency department point-of-care ultrasound for rib fracture diagnosis in minor thoracic injury.

    Science.gov (United States)

    Lalande, Élizabeth; Guimont, Chantal; Émond, Marcel; Parent, Marc Charles; Topping, Claude; Kuimi, Brice Lionel Batomen; Boucher, Valérie; Le Sage, Natalie

    2017-05-01

    The main objective of this study was to evaluate the feasibility of emergency department (ED) point-of-care ultrasound (PoCUS) for rib fracture diagnosis in patients with minor thoracic injury (mTI). Secondary objectives were to 1) evaluate patients' pain during the PoCUS procedure, 2) identify the limitations of the use of PoCUS technique, and 3) compare the diagnosis obtained with PoCUS to radiography results. Adult patients who presented with clinical suspicion of rib fractures after mTI were included. All patients underwent PoCUS performed by emergency physicians (EPs) prior to a rib view X-ray. A visual analogue scale (VAS) ranging from 0 to 100 was used to ascertain feasibility, patients' pain and clinicians' degree of certitude. Feasibility was defined as a score of more than 50 on the VAS. We documented the radiologists' interpretation of rib view X-ray. Radiologists were blinded to the PoCUS results. Ninety-six patients were included. A majority (65%) of EPs concluded that the PoCUS technique to diagnose rib fracture was feasible (VAS score > 50). Median score for feasibility was 63. Median score was 31 (Interquartile range [IQR] 5-57) for patients' pain related to the PoCUS. The main limiting factor of the PoCUS technique was pain during patient examination (15%). PoCUS examination appears to be a feasible technique for a rib fracture diagnosis in the ED.

  1. Atrophy and Primary Somatosensory Cortical Reorganization after Unilateral Thoracic Spinal Cord Injury: A Longitudinal Functional Magnetic Resonance Imaging Study

    Directory of Open Access Journals (Sweden)

    Jia-Sheng Rao

    2013-01-01

    Full Text Available The effects of traumatic spinal cord injury (SCI on the changes in the central nervous system (CNS over time may depend on the dynamic interaction between the structural integrity of the spinal cord and the capacity of the brain plasticity. Functional magnetic resonance imaging (fMRI was used in a longitudinal study on five rhesus monkeys to observe cerebral activation during upper limb somatosensory tasks in healthy animals and after unilateral thoracic SCI. The changes in the spinal cord diameters were measured, and the correlations among time after the lesion, structural changes in the spinal cord, and primary somatosensory cortex (S1 reorganization were also determined. After SCI, activation of the upper limb in S1 shifted to the region which generally dominates the lower limb, and the rostral spinal cord transverse diameter adjacent to the lesion exhibited obvious atrophy, which reflects the SCI-induced changes in the CNS. A significant correlation was found among the time after the lesion, the spinal cord atrophy, and the degree of contralateral S1 reorganization. The results indicate the structural changes in the spinal cord and the dynamic reorganization of the cerebral activation following early SCI stage, which may help to further understand the neural plasticity in the CNS.

  2. Is chest x-ray an adequate screening tool for the diagnosis of blunt thoracic aortic injury?

    Science.gov (United States)

    Ekeh, Akpofure Peter; Peterson, Wylan; Woods, Randy J; Walusimbi, Mbaga; Nwuneli, Nancy; Saxe, Jonathan M; McCarthy, Mary C

    2008-11-01

    Blunt thoracic aortic injuries (BTAI) have a high mortality rate. For survivors, chest X-ray (CXR) findings are used to determine the need for further diagnostic testing with chest computerized tomography with angiography (CTA) or conventional angiography. We set to determine the adequacy of utilizing CXR alone as a screening tool for BTAI. All patients diagnosed with BTAI at a level I trauma-center during a 7-year-period were identified. CXRs of these patients and those of a control group of blunt trauma patients with an injury severity score >15 were reviewed by four trauma surgeons blinded to the diagnosis. Based on each CXR viewed, the surgeons decided if they would have proceeded to chest CTA, angiography, or required no further studies to rule out BTAI. In the 7-year-period, 83 patients had BTAI. CXRs were available in 45 patients. The four surgeons viewed 96 CXRs including those of 51 controls. Based on the CXR appearance in patients with BTAI, the surgeons chose to proceed to chest CTA in 38 patients (84.4%), conventional aortography in two patients (4.4%), and no further testing in five patients (11.2%). A widened mediastinum (75%) and loss of the aorto-pulmonary window (40%) were the most frequent CXR abnormalities. Patients with BTAI were more likely to have an abnormal CXR-40 of 45 (88.8%) patients when compared with the controls-25 of 51 (49%)patients-p < 0.001. Although CXR is a sensitive screening modality, it failed to identify the possibility of BTAI in 11% of patients. The liberal use of chest CTA after high speed motor vehicle crashes is recommended to minimize the incidence of missed BTAI.

  3. IL-6 is a potential marker for radiation pneumonitis: a prospective clinical study of circulating cytokines in predicting radiation pulmonary injury

    International Nuclear Information System (INIS)

    Chen Yuhchyau; Rubin, Philip; McDonald, Sandra; Finkelstein, Jacob; Smudzin, Therese; Hernady, Eric; Williams, Jacqueline

    1997-01-01

    Purpose/Objective: The use of radiotherapy in eradicating thoracic malignancy is limited by the normal lung tissue tolerance to ionizing radiation. Subacute and late radiation pulmonary toxicity manifests as radiation pneumonitis and ultimately lung fibrosis. Recently, the addition of chemotherapy or a biologic response modifier to radiation has become the standard therapy for inoperable lung cancer. The radiosensitizing effect of these agents is associated with an increased risk of radiation pulmonary injury and treatment related mortality. The search for a serum marker for predicting radiation pulmonary injury will help us understand the mechanism leading to such events and find possible interventions to prevent the adverse outcome. Unpublished data from our laboratory suggested that following a single dose of radiation, there was a dose-related elevation in IL-6 protein levels in the lung of radiation fibrosis prone mice. Based on this information, a prospective clinical study of circulating cytokine levels and its application to predict radiation induced pulmonary injury was conducted at University of Rochester. Preliminary results revealed promising information in identifying a circulating cytokine as a predictor for radiation pneumonitis. Materials and Methods: Eighteen patients receiving thoracic irradiation for primary thoracic malignancy were registered in the study. Radiation pneumonitis was determined by subjective respiratory symptoms assessed according to RTOG morbidity scoring criteria. Pretreatment and serial post-therapy chest X-ray, chest CT scan and pulmonary function tests were obtained. Radiation fibrosis was determined by radiographic changes in irradiated normal lung using a scoring system which quantified the extent of loss of air content, degree of opacification, anatomic extent of involvement, air bronchogram, pleural thickening, or effusion. Plasma levels of interleukin-6 (IL-6), tumor necrosis factor (TNF), transforming growth factor

  4. Dosimetric effect of beam arrangement for intensity-modulated radiation therapy in the treatment of upper thoracic esophageal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Fu, Yuchuan [Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Deng, Min; Zhou, Xiaojuan [Department of Thoracic Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Lin, Qiang; Du, Bin [Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Tian, Xue; Xu, Yong; Wang, Jin; Lu, You [Department of Thoracic Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Gong, Youling, E-mail: gongyouling@hotmail.com [Department of Thoracic Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China)

    2017-04-01

    To evaluate the lung sparing in intensity-modulated radiation therapy (IMRT) for patients with upper thoracic esophageal tumors extending inferiorly to the thorax by different beam arrangement. Overall, 15 patient cases with cancer of upper thoracic esophagus were selected for a retrospective treatment-planning study. Intensity-modulated radiation therapy plans using 4, 5, and 7 beams (4B, 5B, and 7B) were developed for each patient by direct machine parameter optimization (DMPO). All plans were evaluated with respect to dose volumes to irradiated targets and normal structures, with statistical comparisons made between 4B with 5B and 7B intensity-modulated radiation therapy plans. Differences among plans were evaluated using a two-tailed Friedman test at a statistical significance of p < 0.05. The maximum dose, average dose, and the conformity index (CI) of planning target volume 1 (PTV1) were similar for 3 plans for each case. No significant difference of coverage for planning target volume 1 and maximum dose for spinal cords were observed among 3 plans in present study (p > 0.05). The average V{sub 5}, V{sub 13}, V{sub 20}, mean lung dose, and generalized equivalent uniform dose (gEUD) for the total lung were significantly lower in 4B-plans than those data in 5B-plans and 7B-plans (p < 0.01). Although the average V{sub 30} for the total lung were significantly higher in 4B-plans than those in 5B-plans and 7B-plans (p < 0.05). In addition, when comparing with the 4B-plans, the conformity/heterogeneity index of the 5B- and 7B-plans were significantly superior (p < 0.05). The 4B-intensity-modulated radiation therapy plan has advantage to address the specialized problem of lung sparing to low- and intermediate-dose exposure in the thorax when dealing with relative long tumors extended inferiorly to the thoracic esophagus for upper esophageal carcinoma with the cost for less conformity. Studies are needed to compare the superiority of volumetric modulated arc therapy

  5. Dosimetric effect of beam arrangement for intensity-modulated radiation therapy in the treatment of upper thoracic esophageal carcinoma

    International Nuclear Information System (INIS)

    Fu, Yuchuan; Deng, Min; Zhou, Xiaojuan; Lin, Qiang; Du, Bin; Tian, Xue; Xu, Yong; Wang, Jin; Lu, You; Gong, Youling

    2017-01-01

    To evaluate the lung sparing in intensity-modulated radiation therapy (IMRT) for patients with upper thoracic esophageal tumors extending inferiorly to the thorax by different beam arrangement. Overall, 15 patient cases with cancer of upper thoracic esophagus were selected for a retrospective treatment-planning study. Intensity-modulated radiation therapy plans using 4, 5, and 7 beams (4B, 5B, and 7B) were developed for each patient by direct machine parameter optimization (DMPO). All plans were evaluated with respect to dose volumes to irradiated targets and normal structures, with statistical comparisons made between 4B with 5B and 7B intensity-modulated radiation therapy plans. Differences among plans were evaluated using a two-tailed Friedman test at a statistical significance of p < 0.05. The maximum dose, average dose, and the conformity index (CI) of planning target volume 1 (PTV1) were similar for 3 plans for each case. No significant difference of coverage for planning target volume 1 and maximum dose for spinal cords were observed among 3 plans in present study (p > 0.05). The average V 5 , V 13 , V 20 , mean lung dose, and generalized equivalent uniform dose (gEUD) for the total lung were significantly lower in 4B-plans than those data in 5B-plans and 7B-plans (p < 0.01). Although the average V 30 for the total lung were significantly higher in 4B-plans than those in 5B-plans and 7B-plans (p < 0.05). In addition, when comparing with the 4B-plans, the conformity/heterogeneity index of the 5B- and 7B-plans were significantly superior (p < 0.05). The 4B-intensity-modulated radiation therapy plan has advantage to address the specialized problem of lung sparing to low- and intermediate-dose exposure in the thorax when dealing with relative long tumors extended inferiorly to the thoracic esophagus for upper esophageal carcinoma with the cost for less conformity. Studies are needed to compare the superiority of volumetric modulated arc therapy with intensity

  6. Radiation resistance and injury of Yersinia enterocolitica

    Energy Technology Data Exchange (ETDEWEB)

    El-Zawahry, Y.A.; Rowley, D.B.

    1979-01-01

    The D values of Yersinia enterocolitica strains IP134, IP107, and WA, irradiated at 25/sup 0/C in Trypticase soy broth, ranged from 9.7 to 11.8 krad. When irradiated in ground beef at 25 and -30/sup 0/C, the D value of strain IP107 and 19.5 and 38.8 krad, respectively. Cells suspended in Trypticase soy broth were more sensitive to storage at -20/sup 0/C than those mixed in ground beef. The percentages of inactivation and of injury (inability to form colonies in the presence of 3.0% NaCl) of cells stored in ground beef for 10 days at -20/sup 0/C were 70 and 23%, respectively. Prior irradiation did not alter the cell's sensitivity to storage at -20/sup 0/C, nor did storage at -20/sup 0/C alter the cell's resistance to irradiation at 25/sup 0/C. Added NaCl concentrations of up to 4.0% in Trypticase soy agar (TSA) (which contains 0.5% NaCl) had little effect on colony formation at 36/sup 0/C of unirradiated Y. enterocolitica. With added 4.0% NaCl, 79% of the cells formed colonies at 36/sup 0/C; with 5.0% NaCl added, no colonies were formed. Although 2.5% NaCl added to ground beef did not sensitize Y. enterocolitica cells to irradiation, when added to TSA it reduced the number of apparent radiation survivors. Cells uninjured by irradiation formed colonies on TSA when incubated at either 36 or 5/sup 0/C. More survivors of an exposure to 60 krad were capable of recovery and forming colonies on TSA when incubated at 36/sup 0/C for 1 day than at 5/sup 0/C for 14 days. This difference in count was considered a manifestation of injury to certain survivors of irradiation.

  7. Radiation resistance and injury of Yersinia enterocolitica

    International Nuclear Information System (INIS)

    El-Zawahry, Y.A.; Rowley, D.B.

    1979-01-01

    The D values of Yersinia enterocolitica strains IP134, IP107, and WA, irradiated at 25 0 C in Trypticase soy broth, ranged from 9.7 to 11.8 krad. When irradiated in ground beef at 25 and -30 0 C, the D value of strain IP107 and 19.5 and 38.8 krad, respectively. Cells suspended in Trypticase soy broth were more sensitive to storage at -20 0 C than those mixed in ground beef. The percentages of inactivation and of injury (inability to form colonies in the presence of 3.0% NaCl) of cells stored in ground beef for 10 days at -20 0 C were 70 and 23%, respectively. Prior irradiation did not alter the cell's sensitivity to storage at -20 0 C, nor did storage at -20 0 C alter the cell's resistance to irradiation at 25 0 C. Added NaCl concentrations of up to 4.0% in Trypticase soy agar (TSA) (which contains 0.5% NaCl) had little effect on colony formation at 36 0 C of unirradiated Y. enterocolitica. With added 4.0% NaCl, 79% of the cells formed colonies at 36 0 C; with 5.0% NaCl added, no colonies were formed. Although 2.5% NaCl added to ground beef did not sensitize Y. enterocolitica cells to irradiation, when added to TSA it reduced the number of apparent radiation survivors. Cells uninjured by irradiation formed colonies on TSA when incubated at either 36 or 5 0 C. More survivors of an exposure to 60 krad were capable of recovery and forming colonies on TSA when incubated at 36 0 C for 1 day than at 5 0 C for 14 days. This difference in count was considered a manifestation of injury to certain survivors of irradiation

  8. Thoracic radiation therapy (RT) before autologous bone marrow transplantation (ABMT) in relapsed or refractory Hodgkin's disease (HD)

    International Nuclear Information System (INIS)

    Tsang, Richard W.; Gospodarowicz, Mary K.; Sutcliffe, Simon B.; Crump, Michael; Keating, Armand

    1997-01-01

    Purpose: To assess the relationship between peri-ABMT RT and treatment-related mortality in patients receiving high-dose chemotherapy (HDCT) and ABMT for recurrent/refractory HD. Materials and Methods: Between 12/1986 and 12/1992, 90 patients (pts) with HD were treated with HDCT (etoposide 60 mg/kg, melphalan 160 mg/m 2 ) +ABMT in Toronto. Fifty-nine of these had all or part of their treatment (RT and/or CT) at the PMH, and they form the basis of this report. HDCT + ABMT was performed for refractory (11 pts) or relapsed (48 pts) HD. The median age at ABMT was 29 (range 16-47), F:M ratio was 1:1.2. Salvage chemotherapy consisted of DHAP (36), mini-BEAM (7), both (8), other chemotherapy (5), and no chemotherapy (3). RT have been incorporated in the salvage treatment with the intent to achieve complete disease control of active disease at relapse or disease progression. RT was given pre-ABMT in 33 pts (3 mantle, 8 mantle with lung, 7 modified mantle excluding axillae, 4 involved field, 1 mantle with TBI, 1 TBI, and 9 non-thoracic), and post-ABMT in 4 pts (2 mantle, 2 modified mantle). Planned RT tumor dose was 35 Gy over 4 weeks (median 35 Gy, range 25-40 Gy), lower doses were used for lung RT (15-17.5 Gy). Treatment-related (TR) mortality was defined as any death occurring within 100 days of ABMT. Autopsies were performed for all patients with TR deaths. Results: We observed 36 deaths, and 10 of these were treatment-related (TR) deaths. With an average follow-up of 4.9 years (range 1.2-7.4 years), the actuarial overall survival was 52% ± 13% at 3 years, and 41% ± 14% at 5 years. Among the 24 patients who received thoracic RT before ABMT, there were 8 TR deaths, with 3 solely attributable to radiation pneumonitis. The remaining 5 TR deaths all had respiratory failure as a major medical problem with complicating sepsis and pancytopenia. The interval from RT to ABMT was shorter for 8 patients dying of TR death (mean 37 days; range 0-103 days), than for the 16 pts with

  9. Mass casualties of radiation injuries after nuclear weapon explosion

    International Nuclear Information System (INIS)

    Messerschmidt, O.

    1980-01-01

    Burns, mechanical lesions, radiation injuries as well as combinations of these types of injuries as a consequence of a nuclear explosion demand different basic lines of triage. The lack of a suitable physical dosimetry is a special problem for the evaluation of radiation injuries. While in cases of wounds and burns treatment, like surgery, is recommended to take place early, for example, within hours or days after those injuries, treatment of radiation victims is necessary only in the stage of severe haematologic changes including disturbances of coagulation and occurrence of high fever which appears after one or two weeks subsequent to exposure. The lack of medical personnel and medical equipment result in even a worse prognosis for the various injuries than in peace time accidents. (orig.) [de

  10. Medical modification of human acute radiation injury

    International Nuclear Information System (INIS)

    Wald, N.; Watson, J.A.

    1977-01-01

    In weighing the benefits and risks of utilizing nuclear energy, there must be a continuing reassessment as nuclear technology develops and changes. The health effects of radiation accidents, as most important part of the risk, must also be reevaluated as our medical ability grows to modify and ameliorate the consequences. The therapeutic efforts were classified as minimal, supportive or heroic. Supportive treatment included reverse isolation, detailed clinical laboratory measurements copious antibiotics, and transfusions of various blood cells, electrolytes and nutrients. Heroic treatment added bone marrow transplantation, while minimal treatment included none of these. It was concluded that while the LD 50 for man is about 340 rads with only minimal treatment, it could be increased to 510 rads with supportive therapy and to over 1,000 rads with heroic treatment. Hematopoietic injury predominated in this exposure range. Finally an estimate of the medical facilities available in the United States to meet these potential clinical needs was made. The relationship of the medical care resources to the likely needs following a serious nuclear power plant accident will be discussed

  11. Alternative radiation-free registration technique for image-guided pedicle screw placement in deformed cervico-thoracic segments.

    Science.gov (United States)

    Kantelhardt, Sven R; Neulen, Axel; Keric, Naureen; Gutenberg, Angelika; Conrad, Jens; Giese, Alf

    2017-10-01

    Image-guided pedicle screw placement in the cervico-thoracic region is a commonly applied technique. In some patients with deformed cervico-thoracic segments, conventional or 3D fluoroscopy based registration of image-guidance might be difficult or impossible because of the anatomic/pathological conditions. Landmark based registration has been used as an alternative, mostly using separate registration of each vertebra. We here investigated a routine for landmark based registration of rigid spinal segments as single objects, using cranial image-guidance software. Landmark based registration of image-guidance was performed using cranial navigation software. After surgical exposure of the spinous processes, lamina and facet joints and fixation of a reference marker array, up to 26 predefined landmarks were acquired using a pointer. All pedicle screws were implanted using image guidance alone. Following image-guided screw placement all patients underwent postoperative CT scanning. Screw positions as well as intraoperative and clinical parameters were retrospectively analyzed. Thirteen patients received 73 pedicle screws at levels C6 to Th8. Registration of spinal segments, using the cranial image-guidance succeeded in all cases. Pedicle perforations were observed in 11.0%, severe perforations of >2 mm occurred in 5.4%. One patient developed a transient C8 syndrome and had to be revised for deviation of the C7 pedicle screw. No other pedicle screw-related complications were observed. In selected patients suffering from pathologies of the cervico-thoracic region, which impair intraoperative fluoroscopy or 3D C-arm imaging, landmark based registration of image-guidance using cranial software is a feasible, radiation-saving and a safe alternative.

  12. Ninety-nine years of radiation injuries in dental radiography

    International Nuclear Information System (INIS)

    Maeda, Kadzuo

    1994-01-01

    A German dentist, F.O. Walkhoff, has started dental radiography as early as two weeks after Roentgen's discovery on November 8, 1895. The purpose of this paper is to revisit radiation injuries by dividing the era into the era of Kells (before World War II) and the era of low exposure doses (after World War II). Edmund Kells (1856-1928), a pioneer of dental radiologist in the United States, has later become a victim of radiation injuries. During the era of Kells, skin radiation injuries were frequent among the group of dental and medical personnels. In the era of low exposure doses, cancers, leukemia, and genetic effects have begun to receive attention. Radiation injuries occurring in a dental practice are discussed in the context of the two eras. (N.K.) 43 refs

  13. Further approaches to biological indicators of radiation injury

    International Nuclear Information System (INIS)

    Koeteles, G.J.; Kormos, C.; Kerekes, J.; Sztanyik, L.B.

    1988-01-01

    Despite of the decades-long investigations, the search for proper biological indicator of radiation injuries did not result in techniques fulfilling all the requirements. So far, the most reliable assay is the dicentric chromosome aberration analysis. New developments have been made recently on a cytogenetic technique, the micronucleus assay, and for local injuries on the application of thermography

  14. Delayed endovascular aortic repair is associated with reduced in-hospital mortality in patients with blunt thoracic aortic injury.

    Science.gov (United States)

    Marcaccio, Christina L; Dumas, Ryan P; Huang, Yanlan; Yang, Wei; Wang, Grace J; Holena, Daniel N

    2018-02-13

    The traditional approach to stable blunt thoracic aortic injury (BTAI) endorsed by the Society for Vascular Surgery is early (<24 hours) thoracic endovascular aortic repair (TEVAR). Recently, some studies have shown improved mortality in stable BTAI patients repaired in a delayed manner (≥24 hours). However, the indications for use of delayed TEVAR for BTAI are not well characterized, and its overall impact on the patient's survival remains poorly understood. We sought to determine whether delayed TEVAR is associated with a decrease in mortality compared with early TEVAR in this population. We conducted a retrospective cohort study of adult patients with BTAI (International Classification of Diseases, Ninth Revision diagnosis code 901.0) who underwent TEVAR (International Classification of Diseases, Ninth Revision procedure code 39.73) from 2009 to 2013 using the National Sample Program data set. Missing physiologic data were imputed using chained multiple imputation. Patients were parsed into groups based on the timing of TEVAR (early, <24 hours, vs delayed, ≥24 hours). The χ 2 , Mann-Whitney, and Fisher exact tests were used to compare baseline characteristics and outcomes of interest between groups. Multivariable logistic regression for mortality was performed that included all variables significant at P ≤ .2 in univariate analyses. A total of 2045 adult patients with BTAI were identified, of whom 534 (26%) underwent TEVAR. Patients with missing data on TEVAR timing were excluded (n = 27), leaving a total of 507 patients for analysis (75% male; 69% white; median age, 40 years [interquartile range, 27-56 years]; median Injury Severity Score [ISS], 34 [interquartile range, 26-41]). Of these, 378 patients underwent early TEVAR and 129 underwent delayed TEVAR. The two groups were similar with regard to age, sex, race, ISS, and presenting physiology. Mortality was 11.9% in the early TEVAR group vs 5.4% in the delayed group, with the early group

  15. Single-incision video-assisted thoracoscopic evaluation and emergent surgery for severe lung and chest wall injury after thoracic trauma in a water park.

    Science.gov (United States)

    Sesma, Julio; Alvarez, Melodie; Lirio, Francisco; Galvez, Carlos; Galiana, Maria; Baschwitz, Benno; Fornes, Francisca; Bolufer, Sergio

    2017-08-01

    Thoracic trauma is a challenging situation with potential severe chest wall and intrathoracic organ injuries. We present a case of emergent surgery in a 23-year-old man with hemorrhagic shock due to massive lung and chest wall injury after thoracic trauma in a water slide. We performed a SI-VATS approach in order to define intrathoracic and chest wall injuries, and once checked the extension of the chest wall injury, we added a middle size thoracotomy just over the affected area in order to stabilize rib fractures with Judet plates, that had caused massive laceration in left lower lobe (LLL) and injured the pericardium causing myocardical tear. After checking bronchial and vascular viability of LLL we suggested a lung parenchyma preserving technique with PTFE protected pulmonary primary suture in order to avoid a lobectomy. Chest tubes were removed on 3 rd postoperative day and patient was discharged on 14 th postoperative day. He has already recovered his normal activity 6 months after surgery.

  16. Sparing of descending axons rescues interneuron plasticity in the lumbar cord to allow adaptive learning after thoracic spinal cord injury

    Directory of Open Access Journals (Sweden)

    Christopher Nelson Hansen

    2016-03-01

    Full Text Available This study evaluated the role of spared axons on structural and behavioral neuroplasticity in the lumbar enlargement after a thoracic spinal cord injury (SCI. Previous work has demonstrated that recovery in the presence of spared axons after an incomplete lesion increases behavioral output after a subsequent complete spinal cord transection (TX. This suggests that spared axons direct adaptive changes in below-level neuronal networks of the lumbar cord. In response to spared fibers, we postulate that lumbar neuron networks support behavioral gains by preventing aberrant plasticity. As such, the present study measured histological and functional changes in the isolated lumbar cord after complete TX or incomplete contusion (SCI. To measure functional plasticity in the lumbar cord, we used an established instrumental learning paradigm. In this paradigm, neural circuits within isolated lumbar segments demonstrate learning by an increase in flexion duration that reduces exposure to a noxious leg shock. We employed this model using a proof-of-principle design to evaluate the role of sparing on lumbar learning and plasticity early (7 days or late (42 days after midthoracic SCI in a rodent model. Early after SCI or TX at 7d, spinal learning was unattainable regardless of whether the animal recovered with or without axonal substrate. Failed learning occurred alongside measures of cell soma atrophy and aberrant dendritic spine expression within interneuron populations responsible for sensorimotor integration and learning. Alternatively, exposure of the lumbar cord to a small amount of spared axons for 6 weeks produced near-normal learning late after SCI. This coincided with greater cell soma volume and fewer aberrant dendritic spines on interneurons. Thus, an opportunity to influence activity-based learning in locomotor networks depends on spared axons limiting maladaptive plasticity. Together, this work identifies a time dependent interaction between

  17. Radiation injuries of plasmatic membrane and lethal action of radiation on cells

    Energy Technology Data Exchange (ETDEWEB)

    Fomenko, B S; Akoev, I G [AN SSSR, Pushchino-na-Oke. Inst. Biologicheskoj Fiziki

    1984-01-01

    Data on modification of procaryotes and eukaryotes cell injuries using preparations not penetrating into cells and also membrane-specific drugs localized in cells in a lipid phase are generalized. A conclusion is drawn that radiation injuries of plasmatic membrane of prokaryotes and eukaryotes contribute considerably to lethal action of radiation on cells.

  18. Radiation injuries of plasmatic membrane and lethal action of radiation on cells

    International Nuclear Information System (INIS)

    Fomenko, B.S.; Akoev, I.G.

    1984-01-01

    Data on modification of procaryotes and eukaryotes cell injuries using preparations not penetrating into cells and also membrane-specific drugs localized in cells in a lipid phase are generalized. A conclusion is drawn that radiation injuries of plasmatic membrane of prokaryotes and eukaryotes contribute considerably to lethal action of radiation on cells

  19. Thoracic CT

    Science.gov (United States)

    ... through a vein (IV) in your hand or forearm. It may be given through the rectum using ... CT scan Vertebra, thoracic (mid back) Normal lung anatomy Thoracic organs References Gotway MB, Panse PM, Gruden ...

  20. Spinal cord blood flow and ischemic injury after experimental sacrifice of thoracic and abdominal segmental arteries.

    Science.gov (United States)

    Etz, Christian D; Homann, Tobias M; Luehr, Maximilian; Kari, Fabian A; Weisz, Donald J; Kleinman, George; Plestis, Konstadinos A; Griepp, Randall B

    2008-06-01

    Spinal cord blood flow (SCBF) after sacrifice of thoracoabdominal aortic segmental arteries (TAASA) during thoracoabdominal aortic aneurysm (TAAA) repair remains poorly understood. This study explored SCBF for 72 h after sacrifice of all TAASA. Fourteen juvenile Yorkshire pigs underwent complete serial TAASA sacrifice (T4-L5). Six control pigs underwent anesthesia and cooling to 32 degrees C with no TAASA sacrifice. In the experimental animals, spinal cord function was continuously monitored using motor evoked potentials (MEPs) until 1h after clamping the last TAASA. Fluorescent microspheres enabled segmental measurement of SCBF along the entire spinal cord before, and 5 min, 1 h, 5 h, 24 h and 72 h after complete TAASA sacrifice. A modified Tarlov score was obtained for 3 days after surgery. All the pigs with complete TAASA sacrifice retained normal cord function (MEP) until 1h after TAASA ligation. Seven pigs (50%) with complete TAASA sacrifice recovered after 72 h; seven pigs suffered paraparesis or paraplegia. Intraoperatively, and until 1h postoperatively, SCBF was similar among the three groups along the entire cord. Postoperatively, SCBF did not decrease in any group, but significant hyperemia occurred at 5h in controls and recovery animals, but did not occur in pigs that developed paraparesis or paraplegia in the T8-L2 segments (p=0.0002) and L3-S segments (p=0.0007). At 24h, SCBF remained marginally lower from T8 caudally; at 72h, SCBF was similar among all groups along the entire cord. SCBF in the segments T8-L2 at 5h predicted functional recovery (p=0.003). This study suggests that critical spinal cord ischemia after complete TAASA sacrifice does not occur immediately (intraoperatively), but is delayed 1-5h or longer after clamping, and represents failure to mount a hyperemic response to rewarming and awakening. The short duration of low SCBF associated with spinal cord injury suggests that hemodynamic and metabolic manipulation lasting only 24-72 h may

  1. Risk factors and early outcomes of acute renal injury after thoracic aortic endograft repair for type B aortic dissection

    Directory of Open Access Journals (Sweden)

    Luo S

    2017-08-01

    Full Text Available Songyuan Luo,* Huanyu Ding,* Jianfang Luo, Wei Li, Bing Ning, Yuan Liu, Wenhui Huang, Ling Xue, Ruixin Fan, Jiyan Chen Cardiology Department, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China *These authors contributed equally to this work Background: Thoracic endovascular aortic repair (TEVAR has become an emerging treatment modality for acute type B aortic dissection (TBAD patients in recent years. The risk factors and impacts of acute kidney injury (AKI after percutaneous TEVAR, however, have not been widely established.Methods: We retrospectively studied the clinical records of 305 consecutive patients who admitted to our institution and had TEVAR for TBAD between December 2009 and June 2013. The patients were routinely monitored for their renal functions preoperatively until 7 days after TEVAR. The Kidney Disease Improving Global Guidelines (KDIGO criteria were used for AKI.Results: Of the total 305 consecutive patients, 84 (27.5% developed AKI after TEVAR, comprising 66 (21.6% patients in KDIGO stage 1, 6 (2.0% patients in stage 2 and 12 (3.9% patients in stage 3. From the logistic regression analysis, systolic blood pressure (SBP on admission >140 mmHg (odds ratio [OR], 2.288; 95% CI, 1.319–3.969 and supra-aortic branches graft bypass hybrid surgery (OR, 3.228; 95% CI, 1.526–6.831 were independent risk factors for AKI after TEVAR. Local anesthesia tended to be a protective factor (OR, 0.563; 95% CI, 0.316–1.001. The preoperative renal function, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or statin administration, volume of contrast agent, range of TBAD and false lumen involving renal artery were not associated with post-operation AKI. The in-hospital mortality and major adverse events were markedly increased with the occurrence of AKI (7.1% vs 0.9%, P=0

  2. [Analysis of pain management in a pre- and post-surgical periods performed for traumatic injury of the lower-thoracic and lumbar portions of the vertebral column].

    Science.gov (United States)

    Bodnarchuk, Iu A; Tanasiĭchuk, O F; Tolstikhin, O V; Holovan', M V

    2013-11-01

    The results of managing of 129 injured persons, treated for injuries of the lower-thoracic and lumbar portions of vertebral column, are adduced. The puncture transcutaneous vertebroplasty was done in 58 patients, stabilizing systems "Sekstant" were installed in 15, the "Mantis" systems--in 13, rigid systems by the open method--in 43. The pain syndrome dynamics was estimated in of the patients in accordance to the visual analogue scale. Positive dynamics in a frame of the pain syndrome regression was noted postoperatively. Differentiated application of various methods of treatment in the patients, suffering nonstable compressional fracture of the lower-thoracic and lumbar portions of vertebral column, permits to reduce anesthesiological risk significantly, to improve the results of treatment, to reduce the patients rehabilitation duration.

  3. Transforming growth factor alpha is a critical mediator of radiation lung injury.

    Science.gov (United States)

    Chung, Eun Joo; Hudak, Kathryn; Horton, Jason A; White, Ayla; Scroggins, Bradley T; Vaswani, Shiva; Citrin, Deborah

    2014-09-01

    Radiation fibrosis of the lung is a late toxicity of thoracic irradiation. Epidermal growth factor (EGF) signaling has previously been implicated in radiation lung injury. We hypothesized that TGF-α, an EGF receptor ligand, plays a key role in radiation-induced fibrosis in lung. Mice deficient in transforming growth factor (TGF-α(-/-)) and control C57Bl/6J (C57-WT) mice were exposed to thoracic irradiation in 5 daily fractions of 6 Gy. Cohorts of mice were followed for survival (n ≥ 5 per group) and tissue collection (n = 3 per strain and time point). Collagen accumulation in irradiated lungs was assessed by Masson's trichrome staining and analysis of hydroxyproline content. Cytokine levels in lung tissue were assessed with ELISA. The effects of TGF-α on pneumocyte and fibroblast proliferation and collagen production were analyzed in vitro. Lysyl oxidase (LOX) expression and activity were measured in vitro and in vivo. Irradiated C57-WT mice had a median survival of 24.4 weeks compared to 48.2 weeks for irradiated TGF-α(-/-) mice (P = 0.001). At 20 weeks after irradiation, hydroxyproline content was markedly increased in C57-WT mice exposed to radiation compared to TGF-α(-/-) mice exposed to radiation or unirradiated C57-WT mice (63.0, 30.5 and 37.6 μg/lung, respectively, P = 0.01). C57-WT mice exposed to radiation had dense foci of subpleural fibrosis at 20 weeks after exposure, whereas the lungs of irradiated TGF-α (-/-) mice were largely devoid of fibrotic foci. Lung tissue concentrations of IL-1β, IL-4, TNF-α, TGF-β and EGF at multiple time points after irradiation were similar in C57-WT and TGF-α(-/-) mice. TGF-α in lung tissue of C57-WT mice rose rapidly after irradiation and remained elevated through 20 weeks. TGF-α(-/-) mice had lower basal LOX expression than C57-WT mice. Both LOX expression and LOX activity were increased after irradiation in all mice but to a lesser degree in TGF-α(-/-) mice. Treatment of NIH-3T3 fibroblasts with TGF

  4. Thoracic spine x-ray

    Science.gov (United States)

    Vertebral radiography; X-ray - spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films ... There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most ...

  5. Occurrence and treatment of radiation injuries following radiotherapy

    International Nuclear Information System (INIS)

    Nakano, Masao

    1978-01-01

    General side effects recognized in digestive organ and hematopoietic organ during radiotherapy were described, and curative medicines for them were mentioned. Countermeasures for dermatitis, reactions of oral, pharyngeal or espophageal mucosae, radiation pneumonitis, radiation enteritis, urinary tract injuries which appeared during radiotherapy were described, and curative medicines for them were mentioned. Skin ulcer, ulcers in oral cavity, and larynx, edema in larynx and lower larynx, bone necrosis, necrosis of thyroid cartilage, injuries of eyeball, radiation damage in lung, delayed injuries following radiotherapy for uterine cancer, nervous system disorder, and lymphatic system disorder were mentioned as main delayed local injuries, and countermeasures for them were described. Lastly, a mental attitude for radiotherapy was described. (Serizawa, K.)

  6. Objected constrained registration and manifold learning: A new patient setup approach in image guided radiation therapy of thoracic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen Ting; Jabbour, Salma K.; Haffty, Bruce G.; Yue, Ning [Radiation Oncology Department, Cancer Institute of New Jersey, University of Medicine and Dentistry of New Jersey, 195 Little Albany Street, New Brunswick, New Jersey 08901 (United States); Qin Songbing [Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215006 (China)

    2013-04-15

    Purpose: The management of thoracic malignancies with radiation therapy is complicated by continuous target motion. In this study, a real time motion analysis approach is proposed to improve the accuracy of patient setup. Methods: For 11 lung cancer patients a long training fluoroscopy was acquired before the first treatment, and multiple short testing fluoroscopies were acquired weekly at the pretreatment patient setup of image guided radiotherapy (IGRT). The data analysis consisted of three steps: first a 4D target motion model was constructed from 4DCT and projected to the training fluoroscopy through deformable registration. Then the manifold learning method was used to construct a 2D subspace based on the target motion (kinetic) and location (static) information in the training fluoroscopy. Thereafter the respiratory phase in the testing fluoroscopy was determined by finding its location in the subspace. Finally, the phase determined testing fluoroscopy was registered to the corresponding 4DCT to derive the pretreatment patient position adjustment for the IGRT. The method was tested on clinical image sets and numerical phantoms. Results: The registration successfully reconstructed the 4D motion model with over 98% volume similarity in 4DCT, and over 95% area similarity in the training fluoroscopy. The machine learning method derived the phase values in over 98% and 93% test images of the phantom and patient images, respectively, with less than 3% phase error. The setup approach achieved an average accumulated setup error less than 1.7 mm in the cranial-caudal direction and less than 1 mm in the transverse plane. All results were validated against the ground truth of manual delineations by an experienced radiation oncologist. The expected total time for the pretreatment setup analysis was less than 10 s. Conclusions: By combining the registration and machine learning, the proposed approach has the potential to improve the accuracy of pretreatment setup for

  7. Objected constrained registration and manifold learning: A new patient setup approach in image guided radiation therapy of thoracic cancer

    International Nuclear Information System (INIS)

    Chen Ting; Jabbour, Salma K.; Haffty, Bruce G.; Yue, Ning; Qin Songbing

    2013-01-01

    Purpose: The management of thoracic malignancies with radiation therapy is complicated by continuous target motion. In this study, a real time motion analysis approach is proposed to improve the accuracy of patient setup. Methods: For 11 lung cancer patients a long training fluoroscopy was acquired before the first treatment, and multiple short testing fluoroscopies were acquired weekly at the pretreatment patient setup of image guided radiotherapy (IGRT). The data analysis consisted of three steps: first a 4D target motion model was constructed from 4DCT and projected to the training fluoroscopy through deformable registration. Then the manifold learning method was used to construct a 2D subspace based on the target motion (kinetic) and location (static) information in the training fluoroscopy. Thereafter the respiratory phase in the testing fluoroscopy was determined by finding its location in the subspace. Finally, the phase determined testing fluoroscopy was registered to the corresponding 4DCT to derive the pretreatment patient position adjustment for the IGRT. The method was tested on clinical image sets and numerical phantoms. Results: The registration successfully reconstructed the 4D motion model with over 98% volume similarity in 4DCT, and over 95% area similarity in the training fluoroscopy. The machine learning method derived the phase values in over 98% and 93% test images of the phantom and patient images, respectively, with less than 3% phase error. The setup approach achieved an average accumulated setup error less than 1.7 mm in the cranial-caudal direction and less than 1 mm in the transverse plane. All results were validated against the ground truth of manual delineations by an experienced radiation oncologist. The expected total time for the pretreatment setup analysis was less than 10 s. Conclusions: By combining the registration and machine learning, the proposed approach has the potential to improve the accuracy of pretreatment setup for

  8. A novel radiation responsive cis-acting element regulates gene induction and mediates tissue injury

    International Nuclear Information System (INIS)

    Hallahan, Dennis E.; Virudachalam, Subbulakshmi; Kuchibahtla, Jaya

    1997-01-01

    Purpose: The intracellular adhesion molecule (ICAM-1) binds and activates inflammatory cells and thereby contributes to the pathogenesis of tissue injury. To characterize a model for radiation-induction of tissue injury, we studied radiation-mediated lung injury in mice deficient in the ICAM-1 gene. To study the mechanisms of x-ray mediated ICAM induction, we studied transcriptional activation of the ICAM promoter and nuclear protein binding to the 5' untranslated region of the ICAM gene. Methods: Immunohistochemistry and immunofluorescence were used to study the histologic pattern of ICAM expression in irradiated tissue. The ICAM-1 knockout mice were bred with wild type mice to create heterozygous mice with attenuated ICAM expression. ICAM -/-, ICAM+/- and ICAM +/+ mice were treated with thoracic irradiation and lung sections were stained for leukocyte common antigen (CD45) to study inflammation. To study the mechanism of x-ray induction of ICAM, we linked the 5' untranslated region of the ICAM gene to the luciferase reporter gene and delated DNA segments from the promoter to determine which elements are required for induction. We performed electrophoretic mobility shift analysis of nuclear proteins from irradiated endothelial cells to study transcription factor activation. Results: Immunohistochemistry showed dose and time dependent increases in ICAM protein expression in irradiated lungs which was prolonged as compared to endothelial cells in vitro. The histologic pattern of ICAM expression was in the capillary endothelium and was distinct from the pattern of expression of other radiation-inducible adhesion molecules. ICAM knockout mice had no ICAM expression and no inflammatory cell accumulation in the irradiated lung. ICAM+/+ mice developed leukocyte adhesion to irradiated endothelium within hours of irradiation and radiation pneumonitis 5 to 6 weeks later. The DNA sequence between -981 and -769 (relative to start codon) contains two 16-base pair repeats, each

  9. Surgical management of radiation injury to the small intestine

    Energy Technology Data Exchange (ETDEWEB)

    Swan, R.W.; Fowler, W.C. Jr., Boronow, R.C.

    1976-01-01

    Severe injury of the small intestine represents one of the most tragic complications of radiation of the pelvis and abdomen. Not uncommonly, patients die from the radiation or the treatment of its intestinal complications. More commonly, patients become intestinal cripples, secondary to chronic partial obstruction of the small intestine and malnutrition associated with the stagnant loop syndrome, as previously reported by one of us. Management results have been discouraging, usually because of a general lack of clinical recognition and understanding of radiation injury to the intestine. Medical management has not been satisfactory. It may provide temporary relief from symptoms, but not long-lasting. Surgical management, although frequently curative, has been associated with high death and morbidity rates. Many surgical procedures have been used in treating radiation injury to the small intestine. Generally, these fall into two categories: first, intestinal resection with primary anastomosis; and second, enteroenteric or enterocolic bypass. In the literature are reflected advocates for each method of surgical management.

  10. Prevalence and Clinical Import of Thoracic Injury Identified by Chest Computed Tomography but Not Chest Radiography in Blunt Trauma: Multicenter Prospective Cohort Study.

    Science.gov (United States)

    Langdorf, Mark I; Medak, Anthony J; Hendey, Gregory W; Nishijima, Daniel K; Mower, William R; Raja, Ali S; Baumann, Brigitte M; Anglin, Deirdre R; Anderson, Craig L; Lotfipour, Shahram; Reed, Karin E; Zuabi, Nadia; Khan, Nooreen A; Bithell, Chelsey A; Rowther, Armaan A; Villar, Julian; Rodriguez, Robert M

    2015-12-01

    Chest computed tomography (CT) diagnoses more injuries than chest radiography, so-called occult injuries. Wide availability of chest CT has driven substantial increase in emergency department use, although the incidence and clinical significance of chest CT findings have not been fully described. We determine the frequency, severity, and clinical import of occult injury, as determined by changes in management. These data will better inform clinical decisions, need for chest CT, and odds of intervention. Our sample included prospective data (2009 to 2013) on 5,912 patients at 10 Level I trauma center EDs with both chest radiography and chest CT at physician discretion. These patients were 40.6% of 14,553 enrolled in the parent study who had either chest radiography or chest CT. Occult injuries were pneumothorax, hemothorax, sternal or greater than 2 rib fractures, pulmonary contusion, thoracic spine or scapula fracture, and diaphragm or great vessel injury found on chest CT but not on preceding chest radiography. A priori, we categorized thoracic injuries as major (having invasive procedures), minor (observation or inpatient pain control >24 hours), or of no clinical significance. Primary outcome was prevalence and proportion of occult injury with major interventions of chest tube, mechanical ventilation, or surgery. Secondary outcome was minor interventions of admission rate or observation hours because of occult injury. Two thousand forty-eight patients (34.6%) had chest injury on chest radiography or chest CT, whereas 1,454 of these patients (71.0%, 24.6% of all patients) had occult injury. Of these, in 954 patients (46.6% of injured, 16.1% of total), chest CT found injuries not observed on immediately preceding chest radiography. In 500 more patients (24.4% of injured patients, 8.5% of all patients), chest radiography found some injury, but chest CT found occult injury. Chest radiography found all injuries in only 29.0% of injured patients. Two hundred and two

  11. Effects of radiation, burn and combined radiation-burn injury on hemodynamics

    International Nuclear Information System (INIS)

    Ye Benlan; Cheng Tianming; Xiao Jiasi

    1996-01-01

    Changes in hemodynamics after radiation, burn and combined radiation burn injury within eight hours post injury were studied. The results indicate: (1) Shock of rats in the combined injury group is more severe than that in the burn group. One of the reasons is that the blood volume in the combined injury group is less than that in the burn group. Radiation injury plays an important role in this effect, which enhances the increase in vascular permeability and causes the loss of plasma. (2) Decrease in cardiac output and stroke work and increase in vascular resistance in the combined radiation burn group are more drastic than those in the burn group, which may cause and enhance shock. Replenishing fluid is useful for recovery of hemodynamics. (3) Rb uptake is increased in the radiation group which indicates that compensated increase of myocardial nutritional blood flow may take place before the changes of hemodynamics and shock. Changes of Rb uptake in the combined injury group is different from that in the radiation groups and in the burn group. The results also suggest that changes of ion channel activities may occur to a different extent after injury. (4) Verapamil is helpful to the recovery of hemodynamics post injury. It is better to combine verapamil with replenishing fluid

  12. The role of whole-body computed tomography in the diagnosis of thoracic injuries in severely injured patients - a retrospective multi-centre study based on the trauma registry of the German trauma society (TraumaRegister DGU®).

    Science.gov (United States)

    Lang, Patricia; Kulla, Martin; Kerwagen, Fabian; Lefering, Rolf; Friemert, Benedikt; Palm, Hans-Georg

    2017-08-15

    Thoracic injuries are a leading cause of death in polytrauma patients. Early diagnosis and treatment are of paramount importance. Whole-body computed tomography (WBCT) has largely replaced traditional imaging techniques such as conventional radiographs and focused computed tomography (CT) as diagnostic tools in severely injured patients. It is still unclear whether WBCT has led to higher rates of diagnosis of thoracic injuries and thus to a change in outcomes. In a retrospective study based on the trauma registry of the German Trauma Society (TraumaRegister DGU ® ), we analysed data from 16,545 patients who underwent treatment in 59 hospitals between 2002 and 2012 (ISS ≥ 9). The 3 years preceding and the 3 years following the introduction of WBCT as a standard imaging modality for the investigation of severely injured patients were assessed for every hospital. Accordingly, patients were assigned to either the pre-WBCT or the WBCT group. We compared the numbers of thoracic injuries and the outcomes of patients before and after the routine use of WBCT. A total of 13,564 patients (pre-WBCT: n = 5005, WBCT: n = 8559) were included. Relevant thoracic injuries were detected in 47.8%. There were no major differences between the patient groups in injury severity (pre-WBCT: median ISS 21; WBCT: median ISS 22), injury patterns and demographics. After the introduction of WBCT, only minor changes were observed regarding the rates of most thoracic injuries. Clinically relevant injuries were pulmonary contusions (pre-WBCT: 18.5%; WBCT: 28.7%), injuries to the lung parenchyma (pre-WBCT: 12.6%; WBCT: 5.9%), multiple rib fractures (pre-WBCT: 10.6%; WBCT: 21.6%), and pneumothoraces (pre-WBCT: 17.3%; WBCT: 21.6%). The length of stay in the intensive care unit (pre-WBCT: 10.8 days; WBCT: 9.7 days) and in hospital (pre-WBCT: 26.2 days; WBCT: 23.3 days) decreased. There was no difference in overall mortality (pre-WBCT: 15.5%; WBCT: 15.6%). The routine use of WBCT in the

  13. Assessment of radiation injuries: role of nuclear magnetic resonance

    International Nuclear Information System (INIS)

    Khushu, Subhash; Rana, Poonam

    2014-01-01

    In the event of an intentional or accidental release of ionizing radiation, timely assessment of the radiation exposure is critical for the triage and to facilitate timely and optimal medical care to the effected population. In addition to mild to severe injuries to tissues and organs, radiation injury can also cause cognitive decline, depressive behavior and affective state disturbances following exposure to both high and low doses of radiation. These may be even seen without evident tissue injury within hours to days or months to years after exposure to low doses of radiation. In this study, we exploited the multi-parametric contrast of NMR/MRI and its potential to assess radiation dose absorbed and radiation sickness thereof. High resolution NMR spectroscopy experiments were conducted on urine and serum samples collected from mice irradiated (whole body and focal irradiation) with 3, 5 and 8 Gray of γ-radiation at different time points post irradiation. Irradiated mice serum and urine showed distinct metabolic phenotypes and revealed dose and time dependent clustering of irradiated groups depicting different phases of radiation sickness. Increased concentration of urine metabolites related to gut microflora and energy metabolism were observed during different phases of radiation sickness. On the other hand serum spectra reflected changes associated with lipid, energy and membrane metabolism during radiation sickness. In vivo NMR spectroscopy and Diffusion Tensor Imaging (DTI) was also performed in different regions of brain post irradiation in animal model, which showed radiation induced metabolite changes in hippocampus region. Fractional anisotropy (FA) and mean diffusivity (MD) also demonstrated dose related changes in various brain regions which corroborated well with the behavioral parameters. The results of the present work lay a scientific foundation for development of high throughput radiation bio-dosimetry. This could further be useful in development

  14. Neurological aspects of acute radiation injuries

    International Nuclear Information System (INIS)

    Torubarov, F.S.; Bushmanov, A.Yu.

    1999-01-01

    Results of the most important clinical studies of human nervous system reactions to acute radiation, carried out at Neurology Clinic of the State Research Center of Russia - Institute of Biophysics are presented. Clinical picture of changes in the nervous system in acute radiation disease caused by homologous and heterologous external irradiation is described. Main neurological syndrome of extremely severe acute radiation disease: acute radiation encephalopathy, radiation toxic encephalopathy, and hemorrhagic syndrome of the central nervous system is distinguished. Relationship between neurological disorders and the geometry of exposure are considered [ru

  15. Dosimetric evaluation of 4 different treatment modalities for curative-intent stereotactic body radiation therapy for isolated thoracic spinal metastases

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Jun [Department of Radiation Oncology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Department of Oncology, First Affiliated Hospital of Xinxiang Medical University, 88 Jiankang Road, Weihui, Henan, 453100 (China); Ma, Lin [Department of Radiation Oncology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Department of Radiation Oncology, Hainan Branch of Chinese PLA General Hospital, Haitang Bay, Sanya, 572000 (China); Wang, Xiao-Shen; Xu, Wei Xu; Cong, Xiao-Hu; Xu, Shou-Ping; Ju, Zhong-Jian [Department of Radiation Oncology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Du, Lei [Department of Radiation Oncology, Hainan Branch of Chinese PLA General Hospital, Haitang Bay, Sanya, 572000 (China); Cai, Bo-Ning [Department of Radiation Oncology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Yang, Jack [Department of Radiation Oncology, Monmouth Medical Center, 300 2nd Avenue, Long Branch, NJ 07740 (United States)

    2016-07-01

    To investigate the dosimetric characteristics of 4 SBRT-capable dose delivery systems, CyberKnife (CK), Helical TomoTherapy (HT), Volumetric Modulated Arc Therapy (VMAT) by Varian RapidArc (RA), and segmental step-and-shoot intensity-modulated radiation therapy (IMRT) by Elekta, on isolated thoracic spinal lesions. CK, HT, RA, and IMRT planning were performed simultaneously for 10 randomly selected patients with 6 body types and 6 body + pedicle types with isolated thoracic lesions. The prescription was set with curative intent and dose of either 33 Gy in 3 fractions (3F) or 40 Gy in 5F to cover at least 90% of the planning target volume (PTV), correspondingly. Different dosimetric indices, beam-on time, and monitor units (MUs) were evaluated to compare the advantages/disadvantages of each delivery modality. In ensuring the dose-volume constraints for cord and esophagus of the premise, CK, HT, and RA all achieved a sharp conformity index (CI) and a small penumbra volume compared to IMRT. RA achieved a CI comparable to those from CK, HT, and IMRT. CK had a heterogeneous dose distribution in the target as its radiosurgical nature with less dose uniformity inside the target. CK had the longest beam-on time and the largest MUs, followed by HT and RA. IMRT presented the shortest beam-on time and the least MUs delivery. For the body-type lesions, CK, HT, and RA satisfied the target coverage criterion in 6 cases, but the criterion was satisfied in only 3 (50%) cases with the IMRT technique. For the body + pedicle-type lesions, HT satisfied the criterion of the target coverage of ≥90% in 4 of the 6 cases, and reached a target coverage of 89.0% in another case. However, the criterion of the target coverage of ≥90% was reached in 2 cases by CK and RA, and only in 1 case by IMRT. For curative-intent SBRT of isolated thoracic spinal lesions, RA is the first choice for the body-type lesions owing to its delivery efficiency (time); the second choice is CK or HT; HT is the

  16. Dosimetric evaluation of 4 different treatment modalities for curative-intent stereotactic body radiation therapy for isolated thoracic spinal metastases

    International Nuclear Information System (INIS)

    Yang, Jun; Ma, Lin; Wang, Xiao-Shen; Xu, Wei Xu; Cong, Xiao-Hu; Xu, Shou-Ping; Ju, Zhong-Jian; Du, Lei; Cai, Bo-Ning; Yang, Jack

    2016-01-01

    To investigate the dosimetric characteristics of 4 SBRT-capable dose delivery systems, CyberKnife (CK), Helical TomoTherapy (HT), Volumetric Modulated Arc Therapy (VMAT) by Varian RapidArc (RA), and segmental step-and-shoot intensity-modulated radiation therapy (IMRT) by Elekta, on isolated thoracic spinal lesions. CK, HT, RA, and IMRT planning were performed simultaneously for 10 randomly selected patients with 6 body types and 6 body + pedicle types with isolated thoracic lesions. The prescription was set with curative intent and dose of either 33 Gy in 3 fractions (3F) or 40 Gy in 5F to cover at least 90% of the planning target volume (PTV), correspondingly. Different dosimetric indices, beam-on time, and monitor units (MUs) were evaluated to compare the advantages/disadvantages of each delivery modality. In ensuring the dose-volume constraints for cord and esophagus of the premise, CK, HT, and RA all achieved a sharp conformity index (CI) and a small penumbra volume compared to IMRT. RA achieved a CI comparable to those from CK, HT, and IMRT. CK had a heterogeneous dose distribution in the target as its radiosurgical nature with less dose uniformity inside the target. CK had the longest beam-on time and the largest MUs, followed by HT and RA. IMRT presented the shortest beam-on time and the least MUs delivery. For the body-type lesions, CK, HT, and RA satisfied the target coverage criterion in 6 cases, but the criterion was satisfied in only 3 (50%) cases with the IMRT technique. For the body + pedicle-type lesions, HT satisfied the criterion of the target coverage of ≥90% in 4 of the 6 cases, and reached a target coverage of 89.0% in another case. However, the criterion of the target coverage of ≥90% was reached in 2 cases by CK and RA, and only in 1 case by IMRT. For curative-intent SBRT of isolated thoracic spinal lesions, RA is the first choice for the body-type lesions owing to its delivery efficiency (time); the second choice is CK or HT; HT is the

  17. The effect of patient-specific factors on radiation-induced regional lung injury

    International Nuclear Information System (INIS)

    Garipagaoglu, Melahat; Munley, Michael T.; Hollis, Donna; Poulson, Jean M.; Bentel, Gunilla C.; Sibley, Gregory; Anscher, Mitchell S.; Fan Ming; Jaszczak, Ronald J.; Coleman, R. Edward; Marks, Lawrence B.

    1999-01-01

    Purpose: To assess the impact of patient-specific factors on radiation (RT)-induced reductions in regional lung perfusion. Methods: Fifty patients (32 lung carcinoma, 7 Hodgkin's disease, 9 breast carcinoma and 2 other thoracic tumors) had pre-RT and ≥24-week post-RT single photon emission computed tomography (SPECT) perfusion images to assess the dose dependence of RT-induced reductions in regional lung perfusion. The SPECT data were analyzed using a normalized and non-normalized approach. Furthermore, two different mathematical methods were used to assess the impact of patient-specific factors on the dose-response curve (DRC). First, DRCs for different patient subgroups were generated and compared. Second, in a more formal statistical approach, individual DRCs for regional lung injury for each patient were fit to a linear-quadratic model (reduction = coefficient 1 x dose + coefficient 2 x dose 2 ). Multiple patient-specific factors including tobacco history, pre-RT diffusion capacity to carbon monoxide (DLCO), transforming growth factor-beta (TGF-β), chemotherapy exposure, disease type, and mean lung dose were explored in a multivariate analysis to assess their impact on the coefficients. Results: None of the variables tested had a consistent impact on the radiation sensitivity of regional lung (i.e., the slope of the DRC). In the formal statistical analysis, there was a suggestion of a slight increase in radiation sensitivity in the dose range >40 Gy for nonsmokers (vs. smokers) and in those receiving chemotherapy (vs. no chemotherapy). However, this finding was very dependent on the specific statistical and normalization method used. Conclusion: Patient-specific factors do not have a dramatic effect on RT-induced reduction in regional lung perfusion. Additional studies are underway to better clarify this issue. We continue to postulate that patient-specific factors will impact on how the summation of regional injury translates into whole organ injury

  18. The cellular basis of renal injury by radiation

    International Nuclear Information System (INIS)

    Williams, M.V.

    1986-01-01

    This review with substantial bibliography summarises renal assay techniques available and discusses the histological and functional studies leading to differing opinions between the belief that vascular injury provides a general explanation of the late effects of radiotherapy and the opposing view that parenchymal cell damage is more important. It is proposed that the link between glomerular and tubular function obscures the primary site of injury and that radiation injury will result in a reduction of functioning nephron mass by primary damage to the tubules or glomeruli. Compensatory renal vasodilation would close a positive feedback loop. Radiation could also cause direct vascular injury; decreased renal perfusion and hypertension would result. Again sensitisation to hypertensive vascular damage would close a feedback loop. (UK)

  19. Combination of autologous bone marrow mesenchymal stem cells and cord blood mononuclear cells in the treatment of chronic thoracic spinal cord injury in 27 cases

    Directory of Open Access Journals (Sweden)

    Lian-zhong WANG

    2012-08-01

    Full Text Available Objective To investigate and evaluate therapeutic effects of transplantation of autologous bone marrow mesenchymal stem cells in conjunction with cord blood mononuclear cells for late thoracic spinal cord injury. Methods Data from 27 patients with late thoracic spinal cord injury who received transplantation of autologous bone marrow mesenchymal stem cells in conjunction with cord blood mononuclear cells in Neurosurgery Department of 463rd Hospital of PLA between July 2006 and July 2008 were collected and analyzed. The full treatment course consisted of 4 consecutive injections at one week apart. Indicators for evaluation followed that of the American Spiral Injury Association (ASIA Impairment Scale (AIS grade, ASIA motor and sensory scores, ASIA visual analog score, and the Ashworth score. The follow-up period was 6 months. Evaluations were made 6 weeks and 6 months after the treatment. Results Improvement from AIS A to AIS B was found in 4 patients. In one patient, improvement from AIS A to AIS C and in one patient from AIS B to AIS C was found 6 weeks after the treatment. The AIS improvement rate was 22.2%. In one patient improvement from AIS A to AIS B was found after 6 months. The overall AIS improvement rate was 25.9%. ASIA baseline motor scores of lower extremties were 0.5±1.5, 1.7±2.9, 3.1±3.6 before the treatment, 6 weeks and 6 months after the treatment, respectively, and showed a statistically significant improvement (P < 0.05. ASIA sensory scores including light touch and pinprick were 66.6±13.7 and 67.0±13.6 respectively before treatment, and they became 68.8±14.4, 68.4±14.7 and 70.5±14.4, 70.2±14.4 six weeks and six months after the treatment. The changes were statistically significant (P < 0.05; Modified Ashworth Scale scores were 1.8±1.5, 1.6±1.2,1.1±0.8 respectively at baseline, 6 weeks and 6months after the treatment, and showed a statistically significant descending trend (P < 0.05. Conclusion Transplantation of

  20. Imaging of thoracic trauma

    International Nuclear Information System (INIS)

    Uffmann, M.; Herold, C.J.; Fuchs, M.

    1998-01-01

    Blunt trauma to the chest results from transfer of kinetic energy to the human body. It may cause a wide range of mostly life-threatening injuries, including fractures of the thoracic skeleton, disintegration of the pleural space, contusion or laceration of pulmonary parenchyma and damage to the mediastinal structures. For a systematic approach it may be helpful to follow an organ-based evaluation of thoracic trauma. However, it should be borne in mind that subtle injuries may be associated with serious complications. Trauma to the chest may affect different anatomic compartments at the same time, requiring and extending diagnostic approach. Conventional radiography plays a major role in diagnosting thoracic trauma, complemented by ultrasound examination of the pleura and abdomen. It is well documented that CT scanning represents a major technological improvement for assessment of thoracic trauma. With the advent of fast helical CT scanning this method becomes more applicable for severly traumatized patients and potentially replaces other time-consuming procedures. State-of-the-art imaging of both projection and cross-sectional techniques provides useful information for immediate and appropriate treatment mandatory in patients with thoracic trauma. (orig.) [de

  1. Anesthesia for plastic reconstruction surgery of radiation injury of neck

    International Nuclear Information System (INIS)

    Lu Yafen; Zhang Junmin; Huang Zhiqin

    1993-01-01

    The management of anesthesia used in the plastic reconstruction of 18 cases of radiation injury of neck is reported. 17 cases were malignant tumor patients. After radiotherapy, their general condition was weak. The injury of neck skin and surrounding tissues was severe. Most operations were excision of the focus and repairing the wound using adjacent flap. The choice of anesthesia depended on the general condition, degree of injury and the procedure. Good pre-operative preparation, close monitoring and satisfactory airway control during operation are very important

  2. Management of radiation injuries of 10 cases of gastrointestinal tracts

    International Nuclear Information System (INIS)

    Tomida, Takashi; Yano, Takashi; Hidaka, Naoaki; Okada, Yoshikatsu; Iwasaki, Makoto; Goshima, Hiromichi.

    1984-01-01

    Ten cases of delayed radiation injuries of the gastrointestinal tracts (consisting of 2 with peptic ulcer, 4 with intestinal obstruction, and 4 with rectal bleeding) are reported. Although conservative therapy or artificial colostomy was undertaken in all cases, satisfactory results were not obtained. In four cases in which subsequent resection of the gastrointestinal tracts was performed, the prognosis was favorable, but various symptoms still continued in the other non-resected cases. Delayed radiation injuries are progressive lesions involving the vasculo-connective tissue, so that cure can not be achieved. Resection of the damaged gastrointestinal tract is recommended, however, this is difficult to do in many cases. (Namekawa, K.)

  3. Management of radiation injuries of 10 cases of gastrointestinal tracts

    Energy Technology Data Exchange (ETDEWEB)

    Tomida, Takashi; Yano, Takashi; Hidaka, Naoaki; Okada, Yoshikatsu; Iwasaki, Makoto; Goshima, Hiromichi

    1984-11-01

    Ten cases of delayed radiation injuries of the gastrointestinal tracts (consisting of 2 with peptic ulcer, 4 with intestinal obstruction, and 4 with rectal bleeding) are reported. Although conservative therapy or artificial colostomy was undertaken in all cases, satisfactory results were not obtained. In four cases in which subsequent resection of the gastrointestinal tracts was performed, the prognosis was favorable, but various symptoms still continued in the other non-resected cases. Delayed radiation injuries are progressive lesions involving the vasculo-connective tissue, so that cure can not be achieved. Resection of the damaged gastrointestinal tract is recommended, however, this is difficult to do in many cases. (Namekawa, K.).

  4. Haemopoietic recovery during radiation disease: Comments on combined-injuries

    International Nuclear Information System (INIS)

    Stevenson, A.F.G.

    1981-01-01

    The regenerative ability of haemopoietic organs during combined radiation injuries has not been adequately investigated. Interactions among individual factors can critically influence the processes involved in haemopoietic recovery. An overview of radiation injuries is given, and a concept towards a hypothetical mode of action at the cellular level is presented. The influence which interacting factors can have on the concentration of pluripotential haemopoietic stem cells is demonstrated by results from an initial experiment. The importance of synergistic and antagonistic reactions is emphasised and commented upon. (orig.) [de

  5. THE DIAGNOSTIC-VALUE OF INTERPEDICULATE DISTANCE ASSESSMENT ON PLAIN FILMS IN THORACIC AND LUMBAR SPINE INJURIES

    NARCIS (Netherlands)

    MARTIJN, A; VELDHUIS, EFM

    1991-01-01

    In a retrospective study of 107 fractured vertebrae in the thoracic and lumbar spine, the interpediculate distance could be accurately assessed on plain roentgenograms in 96%. When these findings were compared with those of conventional tomography, there were no false-positive or false-negative

  6. Study of collagen metabolism after β radiation injury

    International Nuclear Information System (INIS)

    Zhou Yinghui; Xulan; Wu Shiliang; Zhang Xueguang; Chen Liesong

    2000-01-01

    Objective: To investigate the change of collagen metabolism and it's regulation after β radiation. Method: The animal model of β radiation injury was established by the β radiation produced by the linear accelerator; and irradiated NIH 3T3 cells were studied. In the experiment the contents of total collagen, collagen type I and type III were measured. The activity of MMPs-1 was tested. The contents of TGF-β 1 , IL-6 were also detected. Results: After exposure to β radiation, little change was found in the content of total collagen, but the content of collagen I decreased and the content of collagen III, MMPs-1 activity increased; the expression of TGF-β 1 , IL-6 increased. Conclusion: The changes in the metabolism of collagen play an important role in the irradiated injury of the skin; TGF-β 1 and IL-6 may be essential in the regulation of the collagen metabolism

  7. Postoperative Paralysis From Thoracic Ossification of Posterior Longitudinal Ligament Surgery Risk Factor of Neurologic Injury: Nationwide Multiinstitution Survey.

    Science.gov (United States)

    Ito, Zenya; Matsuyama, Yukihiro; Ando, Muneharu; Kawabata, Shigenori; Kanchiku, Tsukasa; Kida, Kazunobu; Fujiwara, Yasushi; Yamada, Kei; Yamamoto, Naoya; Kobayashi, Sho; Saito, Takanori; Wada, Kanichiro; Tadokoro, Nobuaki; Takahashi, Masato; Satomi, Kazuhiko; Shinomiya, Kenichi; Tani, Toshikazu

    2016-10-01

    Retrospective case-control study. The purpose of this study was to examine the factors of postoperative paralysis in patients who have undergone thoracic ossification of posterior longitudinal ligament (OPLL) surgery. A higher percentage of thoracic OPLL patients experience postoperative aggravation of paralysis than cervical OPLL patients, including patients that presented great difficulties in treatment. However, there were a few reports to prevent paralysis thoracic OPLL. The 156 patients who had received thoracic OPLL surgery were selected as the subjects of this study. The items for review were the duration of disease; the preoperative muscle strength (Muscle Manual Testing); OPLL levels (T1/2-4/5: high, T5/6-8/9: middle, and T9/10-11/12: low); the spinal canal occupancy ratio; the ratio of yellow ligament ossification as a complication; the ratio of transcranial-motor evoked potential (Tc-MEP) derivation; the preoperative/postoperative kyphotic angles in the thoracic vertebrae; the correction angle of kyphosis; the duration of surgery; and the amount of bleeding. The subjects were divided into two groups based on the absence or presence of postoperative paralysis to determine the factors of postoperative paralysis. Twenty-three patients (14.7%) exhibited postoperative paralysis. Multivariate analysis identified factors associated with postoperative paralysis: the duration of disease (odds ratio, OR = 3.3); the correction angle of kyphosis (OR = 2.4); and the ratio of Tc-MEP derivation (OR = 2.2). The risk factors of postoperative paralysis are a short duration of disease and a small correction angle of kyphosis. In addition, ratios of Tc-MEP derivation below 50% may anticipate paralysis. 4.

  8. A missed injury leading to delayed diagnosis and postoperative infection of an unstable thoracic spine fracture - case report of a potentially preventable complication

    Directory of Open Access Journals (Sweden)

    Stahel Philip F

    2011-10-01

    Full Text Available Abstract Background Patients suffering from polytrauma often present with altered mental status and have varying levels of examinability. This makes evaluation difficult. Physicians are often required to rely on advanced imaging techniques to make prompt and accurate diagnoses. Occasionally, injury detection on advanced imaging studies can be challenging given the subtle findings associated with certain conditions, such as diffuse idiopathic skeletal hyperostosis (DISH. Delayed or missed diagnoses in the setting of spinal fracture can lead to catastrophic neurological injury. Case presentation A man struck by a motor vehicle suffered multiple traumatic injuries including numerous rib fractures, a mechanically unstable pelvic fracture, and also had suspicion for an aortic injury. Unfortunately, the upper thoracic segment (T1-5 was only visualized with axial images based on the electronic data. Several days later, a contrast CT scan obtained to check the status of suspected aortic injury revealed T3-T4 subluxation indicative of an unstable extension-type fracture in the setting of DISH. Due to the missed injury and delay in diagnosis, surgery was not performed until eight days after the injury. At surgery, the patient was found to have left T3-T4 facet joint infection as well as infected hematoma surrounding a left T4 transverse process fracture and a traumatic T4 costo-transverse joint fracture-subluxation. Despite presence of infection, an instrumented posterior spinal fusion from T1-T6 was performed and the patient recovered well after antibiotic treatment. Conclusion A T3-T4 unstable DISH extension-type fracture was initially missed in a polytrauma patient due to inadequate imaging acquisition, which caused a delay in treatment and bacterial seeding of fracture hematoma. Complete imaging is especially needed in obtunded patients that cannot be thoroughly examined.

  9. Radiation injury in the digestive system after radiotherapy

    International Nuclear Information System (INIS)

    Horie, Yoshiaki; Mishima, Yoshio; Hara, Kosuke; Tomiyama, Jiro; Nakano, Haruo

    1975-01-01

    This paper described the investigation of 18 patients with injury in the digestive system who received surgical procedure after radiotherapy of cancer for the past ten years. The patients consisted of 6 males and 12 females with the age ranging 21 to 66 years old. Primary diseases were 9 cancers of the cervix of the uterus, seminoma and cancer of the ovary, the rectum and the other regions. Radiotherapy was applicable to each of the diseases, and more than 3,000 rads of irradiation given for over a month. Symptoms developed 3 months to 4 and a half years after irradiation and the mean period was about a year except one patient in whom cancer of the colon occurred after 13 years. Operation was performed about several months after the onset of disease in the average. Of 18 patients who received operation, cancer was suspected at preoperative diagnosis in all of 3 patients in whom gastric lesion was resected, 3 of 4 in whom the colon was resected, 1 with small intestine lesion and 1 of 4 with rectum lesion. It was characteristic of these lesions that recurrence of cancer was preoperatively suspected in most of the patients. In the patient with rectum lesion, steroids suppository was given postoperatively. In addition, historical background of radiation injury, difference in period of the occurrence of radiation injury, local injury in delayed period, predisposing cause, classification, symptoms, diagnosis and treatment of radiation injury were also mentioned. (Kanao, N.)

  10. Radiation injury in the digestive system after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Horie, Y; Mishima, Y; Hara, K; Tomiyama, J; Nakano, H [Tokyo Univ. (Japan). Faculty of Medicine

    1975-03-01

    This paper described the investigation of 18 patients with injury in the digestive system who received surgical procedure after radiotherapy of cancer for the past ten years. The patients consisted of 6 males and 12 females with the age ranging 21 to 66 years old. Primary diseases were 9 cancers of the cervix of the uterus, seminoma and cancer of the ovary, the rectum and the other regions. Radiotherapy was applicable to each of the diseases, and more than 3,000 rads of irradiation given for over a month. Symptoms developed 3 months to 4 and a half years after irradiation and the mean period was about a year except one patient in whom cancer of the colon occurred after 13 years. Operation was performed about several months after the onset of disease in the average. Of 18 patients who received operation, cancer was suspected at preoperative diagnosis in all of 3 patients in whom gastric lesion was resected, 3 of 4 in whom the colon was resected, 1 with small intestine lesion and 1 of 4 with rectum lesion. It was characteristic of these lesions that recurrence of cancer was preoperatively suspected in most of the patients. In the patient with rectum lesion, steroids suppository was given postoperatively. In addition, historical background of radiation injury, difference in period of the occurrence of radiation injury, local injury in delayed period, predisposing cause, classification, symptoms, diagnosis and treatment of radiation injury were also mentioned.

  11. Radiation injuries to the skeleton and their orthopedic treatment

    International Nuclear Information System (INIS)

    Franz, R.; Rahnfeld, R.

    1978-01-01

    70 patients subjected to orthopedic treatment and radiotherapy for skeletal tumors have been examined. It was found that serious radiation injuries frequently occurred. Above all there were contractures, disordered healing of wounds, ulcerations, and scolioses and kyphoses of the growing skeleton. Therefore, in the case of diseases of the skeleton, it is recommended to restrain radiotherapy. It has to be rejected in child's age

  12. Circulating miR-29a and miR-150 correlate with delivered dose during thoracic radiation therapy for non-small cell lung cancer

    International Nuclear Information System (INIS)

    Dinh, Tru-Khang T.; Fendler, Wojciech; Chałubińska-Fendler, Justyna; Acharya, Sanket S.; O’Leary, Colin; Deraska, Peter V.; D’Andrea, Alan D.; Chowdhury, Dipanjan; Kozono, David

    2016-01-01

    Risk of normal tissue toxicity limits the amount of thoracic radiation therapy (RT) that can be routinely prescribed to treat non-small cell lung cancer (NSCLC). An early biomarker of response to thoracic RT may provide a way to predict eventual toxicities—such as radiation pneumonitis—during treatment, thereby enabling dose adjustment before the symptomatic onset of late effects. MicroRNAs (miRNAs) were studied as potential serological biomarkers for thoracic RT. As a first step, we sought to identify miRNAs that correlate with delivered dose and standard dosimetric factors. We performed miRNA profiling of plasma samples obtained from five patients with Stage IIIA NSCLC at five dose-points each during radical thoracic RT. Candidate miRNAs were then assessed in samples from a separate cohort of 21 NSCLC patients receiving radical thoracic RT. To identify a cellular source of circulating miRNAs, we quantified in vitro miRNA expression intracellularly and within secreted exosomes in five NSCLC and stromal cell lines. miRNA profiling of the discovery cohort identified ten circulating miRNAs that correlated with delivered RT dose as well as other dosimetric parameters such as lung V20. In the validation cohort, miR-29a-3p and miR-150-5p were reproducibly shown to decrease with increasing radiation dose. Expression of miR-29a-3p and miR-150-5p in secreted exosomes decreased with radiation. This was concomitant with an increase in intracellular levels, suggesting that exosomal export of these miRNAs may be downregulated in both NSCLC and stromal cells in response to radiation. miR-29a-3p and miR-150-5p were identified as circulating biomarkers that correlated with delivered RT dose. miR-150 has been reported to decrease in the circulation of mammals exposed to radiation while miR-29a has been associated with fibrosis in the human heart, lungs, and kidneys. One may therefore hypothesize that outlier levels of circulating miR-29a-3p and miR-150-5p may eventually help

  13. X-ray and radium gamma radiation injuries

    International Nuclear Information System (INIS)

    Fokkema, R.E.

    1993-05-01

    During the period 1896-1939 a number of maxima could be distinguished in the incidence of X-ray and radium gamma ray injuries in patients. An explanation for these fluctuations is investigated in this study. The first distinguishable maximum in the number of reported cases of X-ray injuries can be found in the period 1896-1897 and mainly concerns skin lesions, caused by the lack of shielding and ignorance of the effects. In the period 1904-1905 there was once again an apparent prevalence of radiation injuries to patients. After 1905 the incidence of radiation injuries decreased due to a wider use of dosimetric methods. The third phase of increased injuries may be subdivided into three components. In diagnostic roentgenology from 1896 to 1926 a number of causes of roentgen burns persisted: multiple or long exposures, the use of a short focus-skin-distance and a lack of suitable dosimetric methods. The reduction of complications after 1923 can be attributed to several factors: systematic training of physics who wished to become roentgenologists, greater care of doctors, the use of an alternative method of radiotherapy according to Coutard's method, the introduction of dosimetry with ionization chambers (after 1924), the consensus reached over the roentgen as a unit of applied dosage (in 1928), and the introduction of absorption curves for radiation quality (in 1933). Around 1920 a high complication rate arose as a result of exposure to radiation emitted by radium. In 1922 the first reliable radium dosimetry method came available. This applied to external radium therapy by regular shaped applicators. After 1938 reliable dosimetry was achieved in the field of interstitial radium therapy (brachytherapy). Injuries from radium therapy, however, persisted till about 1940, caused not only by the delayed availability of radium dosimetry, but also to the use of radium therapy by poorly trained radium therapists. 28 figs., 5 tabs

  14. Preliminary analysis of the risk factors for radiation pneumonitis in patients with non- small-cell lung cancer treated with concurrent erlotinib and thoracic radiotherapy

    Directory of Open Access Journals (Sweden)

    Zhuang H

    2014-05-01

    Full Text Available Hongqing Zhuang,* Hailing Hou,* Zhiyong Yuan, Jun Wang, Qingsong Pang, Lujun Zhao, Ping WangDepartment of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, and Tianjin Lung Cancer Center, Tianjin, People's Republic of China*These authors contributed equally to this workPurpose: The aim of this study was to investigate radiation pneumonitis and its associated risk factors in patients with non-small-cell lung cancer treated with concurrent erlotinib and thoracic radiotherapy.Materials and methods: We conducted an analysis of patients with nonoperable stage IIIA–IV non-small-cell lung cancer who were treated with concurrent thoracic radiotherapy and erlotinib (ClinicalTrials.gov identifier: NCT00973310. The Common Terminology Criteria for Adverse Events version 3.0 grading system was applied to evaluate the incidence of radiation pneumonitis. The lung dosimetric parameters were recorded in accordance with the treatment plan, and the study endpoint was radiation pneumonitis at grade 2 or more.Results: Among the 24 selected clinical cases, nine were identified with radiation pneumonitis of grade 2 or above (37.5%. This included four cases with grade 2 (16.7%, two cases with grade 3 (8.3%, and three cases with grade 5 (12.5%. The results showed that the planning target volume was a significant factor affecting the incidence of radiation pneumonitis. All lung dosimetric parameters exhibited statistically significant differences between patients with pneumonitis and patients without pneumonitis. The receiver operating characteristic (ROC curve analysis showed that all lung dosimetric parameters were useful in predicting the incidence of radiation pneumonitis. In addition, the threshold values of V5, V10, V15, V20, V30, and mean lung dose were >4%, >29%, >27%, >22%, >17% and >1,027 cGy, respectively.Conclusion: Special attention

  15. Stem cell, cytokine and plastic surgical management for radiation injuries

    International Nuclear Information System (INIS)

    Akita, Sadanori; Hirano, Akiyoshi; Akino, Kozo

    2008-01-01

    Increasing concern on systemic and local radiation injuries caused by nuclear power plant accident, therapeutic irradiation or nuclear terrorism should be treated and prevented properly for life-saving and improved wound management. We therefore reviewed our therapeutic regimens and for local radiation injuries and propose surgical methods reflecting the importance of the systemic and general conditions. For local radiation injuries, after careful and complete debridement, sequential surgeries with local flap, arterialized or perforator flap and to free flap are used when the patients' general conditions allow. Occasionally, undetermined wound margins in acute emergency radiation injuries and the regenerative surgical modalities should be attempted with temporal artificial dermis impregnated and sprayed with angiogenic factor such as basic fibroblast growth factor (bFGF) and secondary reconstruction can be a candidate for demarcation and saving the donor morbidity. Human mesenchymal stem cells (hMSCs) and adipose-derived stem cells (ADSCs), together with angiogenic and mitogenic factor of basic fibroblast growth factor (bFGF) and an artificial dermis were applied over the excised irradiated skin defect are tested for differentiation and local stimulation effects in the radiation-exposed wounds. The perforator flap and artificial dermal template with growth factor were successful for reconstruction in patients who are suffering from complex underlying disease. Patients were uneventfully treated with minimal morbidities. The hMSCs are strongly proliferative even after 20 Gy irradiation in vitro. Immediate artificial dermis application impregnated with hMSCs and bFGF over the 20 Gy irradiated skin and soft tissues demonstrated the significantly improved fat angio genesis, architected dermal reconstitution and less inflammatory epidermal recovery. Even though emergent cases are more often experienced, detailed understanding of underlying diseases and rational

  16. Stem cell, cytokine and plastic surgical management for radiation injuries

    Energy Technology Data Exchange (ETDEWEB)

    Akita, Sadanori; Hirano, Akiyoshi [Dept. of Plastic and Reconstructive Surgery, Nagasaki (Japan); Akino, Kozo [Nagasaki Univ. (Japan). Graduate School of Biomedical Sciences, Dept. of Neuroanatomy; Ohtsuru, Akira [Nagasaki Univ. Hospital (Japan). Takashi Nagai Memorial, International Hibakusha Medical Center; Yamashita, Shunichi [Nagasaki Univ. School of Medicine (Japan). Atomic Bomb Disease Institute; World Health Organization (WHO), Nagasaki (Japan)

    2008-07-01

    Increasing concern on systemic and local radiation injuries caused by nuclear power plant accident, therapeutic irradiation or nuclear terrorism should be treated and prevented properly for life-saving and improved wound management. We therefore reviewed our therapeutic regimens and for local radiation injuries and propose surgical methods reflecting the importance of the systemic and general conditions. For local radiation injuries, after careful and complete debridement, sequential surgeries with local flap, arterialized or perforator flap and to free flap are used when the patients' general conditions allow. Occasionally, undetermined wound margins in acute emergency radiation injuries and the regenerative surgical modalities should be attempted with temporal artificial dermis impregnated and sprayed with angiogenic factor such as basic fibroblast growth factor (bFGF) and secondary reconstruction can be a candidate for demarcation and saving the donor morbidity. Human mesenchymal stem cells (hMSCs) and adipose-derived stem cells (ADSCs), together with angiogenic and mitogenic factor of basic fibroblast growth factor (bFGF) and an artificial dermis were applied over the excised irradiated skin defect are tested for differentiation and local stimulation effects in the radiation-exposed wounds. The perforator flap and artificial dermal template with growth factor were successful for reconstruction in patients who are suffering from complex underlying disease. Patients were uneventfully treated with minimal morbidities. The hMSCs are strongly proliferative even after 20 Gy irradiation in vitro. Immediate artificial dermis application impregnated with hMSCs and bFGF over the 20 Gy irradiated skin and soft tissues demonstrated the significantly improved fat angio genesis, architected dermal reconstitution and less inflammatory epidermal recovery. Even though emergent cases are more often experienced, detailed understanding of underlying diseases and rational

  17. Postoperative Radiation Therapy With or Without Concurrent Chemotherapy for Node-Positive Thoracic Esophageal Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Junqiang; Pan, Jianji [Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Liu, Jian, E-mail: liujianfj@yahoo.com.cn [Department of Medical Oncology, Fujian Provincial Cancer Hospital, Fuzhou (China); Li, Jiancheng [Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Zhu, Kunshou [Department of Surgery, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Zheng, Xiongwei [Department of Pathology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Chen, Mingqiang [Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Chen, Ming [School of Graduate, Fujian University of Traditional Chinese Medicine, Fuzhou (China); Liao, Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-07-15

    Purpose: To retrospectively compare the efficacy of radiation therapy (RT) and chemotherapy plus RT (CRT) for the postoperative treatment of node-positive thoracic esophageal squamous cell carcinoma (TESCC) and to determine the incidence and severity of toxic reactions. Methods and Materials: We retrospectively reviewed data from 304 patients who had undergone esophagectomy with 3-field lymph node dissection for TESCC and were determined by postoperative pathology to have lymph node metastasis without distant hematogenous metastasis. Of these patients, 164 underwent postoperative chemotherapy (cisplatin 80 mg/m{sup 2}, average days 1-3, plus paclitaxel 135 mg/m{sup 2}, day 1; 21-day cycle) plus RT (50 Gy), and 140 underwent postoperative RT alone. Results: The 5-year overall survival rates for the CRT and RT groups were 47.4% and 38.6%, respectively (P=.030). The distant metastasis rate, the mixed (regional lymph node and distant) metastasis rate, and the overall recurrence rate were significantly lower in the CRT group than in the RT group (P<.05). However, mild and severe early toxic reactions, including neutropenia, radiation esophagitis, and gastrointestinal reaction, were significantly more common in the CRT group than in the RT group (P<.05). No significant differences in incidence of late toxic reactions were found between the 2 groups. Conclusions: Our results show that in node-positive TESCC patients, postoperative CRT is significantly more effective than RT alone at increasing the overall survival and decreasing the rates of distant metastasis, mixed metastasis, and overall recurrence. Severe early toxic reactions were more common with CRT than with RT alone, but patients could tolerate CRT.

  18. The Urine Proteome as a Biomarker of Radiation Injury

    Science.gov (United States)

    Sharma, Mukut; Halligan, Brian D.; Wakim, Bassam T.; Savin, Virginia J.; Cohen, Eric P.; Moulder, John E.

    2009-01-01

    Terrorist attacks or nuclear accidents could expose large numbers of people to ionizing radiation, and early biomarkers of radiation injury would be critical for triage, treatment and follow-up of such individuals. However, no such biomarkers have yet been proven to exist. We tested the potential of high throughput proteomics to identify protein biomarkers of radiation injury after total body X-ray irradiation in a rat model. Subtle functional changes in the kidney are suggested by an increased glomerular permeability for macromolecules measured within 24 hours after TBI. Ultrastructural changes in glomerular podocytes include partial loss of the interdigitating organization of foot processes. Analysis of urine by LC-MS/MS and 2D-GE showed significant changes in the urine proteome within 24 hours after TBI. Tissue kallikrein 1-related peptidase, cysteine proteinase inhibitor cystatin C and oxidized histidine were found to be increased while a number of proteinase inhibitors including kallikrein-binding protein and albumin were found to be decreased post-irradiation. Thus, TBI causes immediately detectable changes in renal structure and function and in the urinary protein profile. This suggests that both systemic and renal changes are induced by radiation and it may be possible to identify a set of biomarkers unique to radiation injury. PMID:19746194

  19. Radiation injury to the temporal bone

    International Nuclear Information System (INIS)

    Guida, R.A.; Finn, D.G.; Buchalter, I.H.; Brookler, K.H.; Kimmelman, C.P.

    1990-01-01

    Osteoradionecrosis of the temporal bone is an unusual sequela of radiation therapy to the head and neck. Symptoms occur many years after the radiation is administered, and progression of the disease is insidious. Hearing loss (sensorineural, conductive, or mixed), otalgia, otorrhea, and even gross tissue extrusion herald this condition. Later, intracranial complications such as meningitis, temporal lobe or cerebellar abscess, and cranial neuropathies may occur. Reported here are five cases of this rare malady representing varying degrees of the disease process. They include a case of radiation-induced necrosis of the tympanic ring with persistent squamous debris in the external auditory canal and middle ear. Another case demonstrates the progression of radiation otitis media to mastoiditis with bony sequestration. Further progression of the disease process is seen in a third case that evolved into multiple cranial neuropathies from skull base destruction. Treatment includes systemic antibiotics, local wound care, and debridement in cases of localized tissue involvement. More extensive debridement with removal of sequestrations, abscess drainage, reconstruction with vascularized tissue from regional flaps, and mastoid obliteration may be warranted for severe cases. Hyperbaric oxygen therapy has provided limited benefit

  20. Radiation risk in the context of liability for injury

    International Nuclear Information System (INIS)

    Riley, Peter

    2003-01-01

    It is perceived by the man in the street that low-level radiation from a nuclear facility is more dangerous than that from other practices. The radiation protection system, in particular the ALARA principle, leads to concerns that even the smallest exposure to radiation is abnormal and dangerous. Public perception of the radiation risk leads to fear in the minds of the public. A consequence of this fear itself may be damage to health in the form of psychological damage or nervous shock. The paper draws attention to the liability for damages by radiation, in particular under the common law of the UK and US, and how liability, determined by the court, is not necessarily influenced by scientific rationality. A natural conclusion may be that a claimant suffering injury of the type caused by radiation and who had been exposed to radiation, no matter how small a dose, that could be shown to come from a nuclear installation would be awarded damages against the licensee of the site of the installation unless it could be shown that the injury was predominantly caused by another source (radioactive or otherwise)

  1. Study of collagen metabolism and regulation after β radiation injury

    International Nuclear Information System (INIS)

    Zhou Yinghui; Xu Lan; Wu Shiliang; Qiu Hao; Jiang Zhi; Tu Youbin; Zhang Xueguang

    2001-01-01

    The animal model of β radiation injury was established by the β radiation produced by the linear accelerator; and irradiated NIH 3T3 cells were studied. In the experiment the contents of total collagen, collagen type I and type III were measured. The activity of MMPs-1 were tested. The contents of TGF-β 1 , IL-6 were also detected. The results showed that after exposure to β radiation, little change was found in the content of total collagen, but the content of collagen I decreased and the content of collagen III, MMPs-1 activity increased; the expression of TGF-β 1 , IL-6 increased. The results suggest that changes in the metabolism of collagen play an important role in the irradiated injury of the skin; TGF-β 1 , IL-6 may be essential in the regulation of the collagen metabolism

  2. Study of collagen metabolism and regulation after {beta} radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Yinghui, Zhou; Lan, Xu; Shiliang, Wu; Hao, Qiu; Zhi, Jiang; Youbin, Tu; Xueguang, Zhang [Suzhou Medical College (China)

    2001-04-01

    The animal model of {beta} radiation injury was established by the {beta} radiation produced by the linear accelerator; and irradiated NIH 3T3 cells were studied. In the experiment the contents of total collagen, collagen type I and type III were measured. The activity of MMPs-1 were tested. The contents of TGF-{beta}{sub 1}, IL-6 were also detected. The results showed that after exposure to {beta} radiation, little change was found in the content of total collagen, but the content of collagen I decreased and the content of collagen III, MMPs-1 activity increased; the expression of TGF-{beta}{sub 1}, IL-6 increased. The results suggest that changes in the metabolism of collagen play an important role in the irradiated injury of the skin; TGF-{beta}{sub 1}, IL-6 may be essential in the regulation of the collagen metabolism.

  3. Device-Training for Individuals with Thoracic and Lumbar Spinal Cord Injury Using a Powered Exoskeleton for Technically Assisted Mobility: Achievements and User Satisfaction

    Science.gov (United States)

    Gillner, Annett; Borgwaldt, Nicole; Kroll, Sylvia; Roschka, Sybille

    2016-01-01

    Objective. Results of a device-training for nonambulatory individuals with thoracic and lumbar spinal cord injury (SCI) using a powered exoskeleton for technically assisted mobility with regard to the achieved level of control of the system after training, user satisfaction, and effects on quality of life (QoL). Methods. Observational single centre study with a 4-week to 5-week intensive inpatient device-training using a powered exoskeleton (ReWalk™). Results. All 7 individuals with SCI who commenced the device-training completed the course of training and achieved basic competences to use the system, that is, the ability to stand up, sit down, keep balance while standing, and walk indoors, at least with a close contact guard. User satisfaction with the system and device-training was documented for several aspects. The quality of life evaluation (SF-12v2™) indicated that the use of the powered exoskeleton can have positive effects on the perception of individuals with SCI regarding what they can achieve physically. Few adverse events were observed: minor skin lesions and irritations were observed; no falls occurred. Conclusions. The device-training for individuals with thoracic and lumbar SCI was effective and safe. All trained individuals achieved technically assisted mobility with the exoskeleton while still needing a close contact guard. PMID:27610382

  4. Device-Training for Individuals with Thoracic and Lumbar Spinal Cord Injury Using a Powered Exoskeleton for Technically Assisted Mobility: Achievements and User Satisfaction

    Directory of Open Access Journals (Sweden)

    Thomas Platz

    2016-01-01

    Full Text Available Objective. Results of a device-training for nonambulatory individuals with thoracic and lumbar spinal cord injury (SCI using a powered exoskeleton for technically assisted mobility with regard to the achieved level of control of the system after training, user satisfaction, and effects on quality of life (QoL. Methods. Observational single centre study with a 4-week to 5-week intensive inpatient device-training using a powered exoskeleton (ReWalk™. Results. All 7 individuals with SCI who commenced the device-training completed the course of training and achieved basic competences to use the system, that is, the ability to stand up, sit down, keep balance while standing, and walk indoors, at least with a close contact guard. User satisfaction with the system and device-training was documented for several aspects. The quality of life evaluation (SF-12v2™ indicated that the use of the powered exoskeleton can have positive effects on the perception of individuals with SCI regarding what they can achieve physically. Few adverse events were observed: minor skin lesions and irritations were observed; no falls occurred. Conclusions. The device-training for individuals with thoracic and lumbar SCI was effective and safe. All trained individuals achieved technically assisted mobility with the exoskeleton while still needing a close contact guard.

  5. Development of Predictive Models of Injury for the Lower Extremity, Lumbar, and Thoracic Spine after discharge from Physical Rehabilitation

    Science.gov (United States)

    2017-10-01

    prediction models will vary by age and sex . Hypothesis 3: A multi-factorial prediction model that accurately predicts risk of new and recurring injuries, as...cleared to return to duty from an injury is of great importance. The purpose of this project is to determine if performance on a battery of...balance screens, measures of power, demographic data and biopsychosocial measures. • Injury data will be collected through self -report, profile data, and

  6. Late radiation injury to muscle and peripheral nerves

    International Nuclear Information System (INIS)

    Gillette, E. L.; Mahler, P. A.; Powers, B. E.; Gillette, S. M.; Vujaskovic, Z.

    1995-01-01

    Late radiation injury to muscles and peripheral nerves is infrequently observed. However, the success of radiation oncology has led to longer patient survival, providing a greater opportunity for late effects to develop, increase in severity and, possibly, impact the quality of life of the patient. In addition, when radiation therapy is combined with surgery and/or chemotherapy, the risk of late complications is likely to increase. It is clear that the incidence of complications involving muscles and nerves increases with time following radiation. The influence of volume has yet to be determined; however, an increased volume is likely to increase the risk of injury to muscles and nerves. Experimental and clinical studies have indicated that the (α(β)) ratio for muscle is approximately 4 Gy and, possibly, 2 Gy for peripheral nerve, indicating the great influence of fractionation on response of these tissues. This is of concern for intraoperative radiation therapy, and for high dose rate brachytherapy. This review of clinical and experimental data discusses the response of muscle and nerves late after radiation therapy. A grading system has been proposed and endpoints suggested

  7. Fatal radiation pneumonia following subclinical busulfan injury

    International Nuclear Information System (INIS)

    Soble, A.R.; Perry, H.

    1977-01-01

    A patient with polycythemia vera received a moderate dose (480 mg) of busulfan intermittently over a 6 year period and later developed Hodgkin's disease. Following split-course upper mantle, chest irradiation, he developed rapidly progressive, fatal pneumonia and bone marrow hypoplasia. It is postulated that the hyperacute organ failures (lung and bone marrow) resulted from augmentation of subclinical busulfan-induced damage of these organs by additive radiation effect. It is recommended that in patients who have had antineoplastic chemotherapy, major radiotherapy to the cervicothoracic region be accompanied by careful monitoring of respiratory and hematopoietic function, both before and during radiotherapy

  8. The protective effect of lycopene against radiation injury to the small intestine of abdominally radiated mice

    International Nuclear Information System (INIS)

    Itoh, Youko; Kurabe, Teruhisa; Ishiguchi, Tsuneo

    2004-01-01

    To reduce the side effects of radiotherapy, radioprotective effects of lycopene on villi and crypts in the small intestine of abdominally radiated mice (15 Gy) were examined with administration pre-, continuous and post-radiation. In the lycopene group, the ratio of the villus length to the crypt was significantly increased in comparison with the radiation only group at 2 days after radiation. At 7 days after radiation, the ratio of necrotic cells in crypt/total was significantly decreased and the ratio of necrotic cells in villus/total was significantly increased by lycopene administration, which indicated an acceleration of the recovery from the radiation injury with lycopene. Each lycopene administered group showed a significant radioprotective effect, with the pre-radiation administration inducing a smaller effect than that of continuous and post-radiation administration. Radiation induced apoptosis was also decreased by lycopene administration. It is concluded that pre-, continuous and post-radiation administration of lycopene protects against radiation injury of the small intestine and accelerate the recovery. (author)

  9. Main stages in the development of radiation immunology: from immunochemical analysis of injury to monitored radiotherapy

    International Nuclear Information System (INIS)

    Yarilin, A.A.; Kashkin, K.P.

    1982-01-01

    The results of research of the radiation action on immunity are presented. The results of immunochemical investigation of radiation tissue injuries are considered. Much attention is given to the problem of radiation injury and repair of the lymphoid system. It is shown that the next stage of development of radiation immunology is immunologic control of radiotherapy of oncologic patients

  10. Possible radiation injury at Koeberg Nuclear Power Station

    International Nuclear Information System (INIS)

    Van Rensburg, L.C.J.; De Villiers, B.; Van Zyl, C.J.

    1986-01-01

    Any injured patient from Koeberg Nuclear Power Station will be treated in the conventional manner as an acute surgical emergency; this has priority over decontamination. The ideal situation is decontamination at Koeberg before ambulance transferral to the Tygerberg Radiation Casualty Facility, but if this is not possible or complete, decontamination can be accomplished by a trained team in the unit. Teamwork is the essence at the place of injury, during transfer, in the decontamination area, in the operating theatre and during the postoperative phase. No surgical management is appropriate or complete without the very necessary guidance and advice from a physicist and the Advisory Group for Radiation Casualties

  11. Central nervous system radiation injury in small animal models

    International Nuclear Information System (INIS)

    Kogel, A.J. van der

    1991-01-01

    Experimental studies on radiation injury in the central nervous system have been carried out in many species ranging from mouse to monkey. This review is restricted to studies in rodents irradiated with low linear energy transfer (LET) radiation. In this paper, the various rodent models of brain and spinal cord injury are described with particular emphasis on the pathology of different types of lesions and theories of their pathogenesis. Many of the initial studies were limited to relatively high single doses, but in later work more clinically relevant fractionated irradiation schemes were employed. This has led to the recognition of various types of early and late delayed injury that are analogous to the syndromes observed in humans. Two main pathways have been suggested for the pathogenesis, one involving predominantly the progressive loss of glial cells and the other involving vascular injury. The relative importance of both mechanisms will be discussed with respect to treatment conditions and to dose level in particular. An hypothesis is presented concerning the possible role of different cell types in the development of specific syndromes

  12. Cytokines in therapy of radiation injury

    International Nuclear Information System (INIS)

    Neta, R.; Oppenheim, J.J.

    1988-01-01

    Repeated injections or infusion of hematopoietic growth factors, such as interleukin-3 (IL-3), granulocyte macrophage-colony stimulating factor (GM-CSF), or granulocyte-colony stimulating factor (G-CSF), accelerate restoration of hematopoiesis in animals compromised by sublethal doses of cytotoxic drugs or irradiation. Previous work by the investigators has shown that IL-1 induced circulating CSF in normal mice and, when used after sublethal irradiation, accelerated the recovery of endogenous splenic colonies. Therefore, IL-1, as well as IFN-gamma, tumor necrosis factor (TNF), G-CSF, and GM-CSF, were evaluated as potential therapeutic agents in irradiated C3H-HeN mice. A single intraperitoneal injection, administered within three hours after a lethal dose (LD)95/30 of irradiation that would kill 95% of mice within 30 days, protected in a dose-dependent manner up to 100% of mice from radiation-induced death due to hematopoietic syndrome. Significant therapeutic effects were also achieved with a single dose of IFN-gamma or of TNF. In contrast, GM-CSF and G-CSF, administered shortly after irradiation, had no effect in the doses used on mice survival

  13. Restoration of radiation injury by ginseng, 3

    International Nuclear Information System (INIS)

    Takeda, Atsuhiko; Katoh, Norio; Yonezawa, Morio

    1982-01-01

    Radiation protection by post-irradiation injection of a thermostable fraction of the ginseng extract in mice, rats and guinea pigs was studied. The thermostable fraction lost ''by-effects'' of decrease in body weight and splenic hyperplasia which were caused in injected mice by the original ginseng extract. The fraction protected mice (male) irradiated with 720 R of X-rays and rats (male) irradiated with 825 R with the dose about 6 mg per 100 g of body weight. The fraction also protected guinea pigs, both female and male, irradiated with 325 R with the dose about 80 mg per 300 g of body weight. The thermostable fraction stimulated recovery of thrombocyte and erythrocyte counts, but not leukocyte counts, in 550-R irradiated mice. Recovery of all the three blood cell counts was stimulated by the fraction in rats irradiated with 630 R and guinea pigs irradiated with 200 R. Comparison of stimulated recovery by the thermostable fraction of the ginseng extract among the three blood cell counts showed that restoring action was the most marked on thrombocyte counts, commonly in the three species of the animals. (author)

  14. Experimental model of cutaneous radiation injury in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Meirelles, Rafael Panisi de Campos [Universidade Federal de Sao Paulo (EPM/UNIFESP), SP (Brazil). Escola Paulista de Medicina; Hochman, Bernardo [Universidade Federal de Sao Paulo (EPM/UNIFESP), SP (Brazil). Escola Paulista de Medicina. Dept. de Cirurgia; Helene Junior, Americo; Fraga, Murillo Francisco Pires [Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FCMSCSP), SP (Brazil). Dept. de Cirurgia. Divisao de Cirurgia Plastica; Lellis, Rute [Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FCMSCSP), SP (Brazil). Divisao de Patologia; Ferreira, Lydia Masako, E-mail: rpcmeirelles@yahoo.com.br, E-mail: lydia.dcir@epm.br [Universidade Federal de Sao Paulo (EPM/UNIFESP), SP (Brazil). Escola Paulista de Mediciana. Divisao de Cirugia Plastica

    2013-07-01

    Purpose: to describe an experimental model of cutaneous radiation injury in rabbits. Methods: on this study eight six-month-old New Zealand male rabbits, with an average weight of 2.5kg were used. They were distributed in four groups (n=2 per group). The control group did not receive radiotherapy and the others received one radiotherapy session of 2000, 3000 and 4500 cGy, respectively. Photographic analysis and histopathological evaluation of the irradiated areas were carried out. Results: after 30 days, the animals from the control group had all their hair grown. In spite of that, the animals from group 2000 cGy had a 60-day alopecia and from group 3000 cGy, a 90-day alopecia. After the 30th day, the 3000cGy group demonstrated 90-day cutaneous radiation injuries, graded 3 and 4. One of the animals from group 4500 cGy died on the 7th day with visceral necrosis. The other from the same group had total skin necrosis. A progressive reduction of glands and blood vessels count and an increase on collagen deposition was observed. Conclusion: The proposed experimental model is reproducible. This study suggests that the dosage 4500cGy is excessive and the 3000 cGy is the most effective for this experimental model of cutaneous radiation injury in rabbits. (author)

  15. Bone marrow transplantation and other treatment after radiation injury

    International Nuclear Information System (INIS)

    Balner, H.

    1977-01-01

    This review deals mainly with current concepts about bone marrow transplantation as therapy for serious radiation injury. Such injury can be classified according to the following broadly defined dose ranges: (1) the supralethal range, leading mainly to the cerebral and intestinal syndromes; (2) the potentially lethal or therapeutic range which causes the bone marrow syndrome, and (3) the sublethal range which rarely leads to injury requiring therapy. The bone marrow syndrome of man and animals is discussed in detail. The optimal therapy for this syndrome is bone marrow transplantation in conjunction with conventional supportive treatment. The principal complications of such therapy are Graft versus Host Disease and a slow recovery of the recipient's immune system. Concerted research activities in a number of institutions have led to considerable progress in the field of bone marrow transplantation. Improved donor selection, new techniques for stem-cell separation and preservation, as well as effective barrier-nursing and antibiotic decontamination, have made bone marrow transplantation an accepted therapy for marrow depression, including the aplasia caused by excessive exposure to radiation. The review also contains a number of guidelines for the handling of serious radiation accidents. (Auth.)

  16. Prophylactic measures of radiation injuries by natural herbs and neutraceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Goyal, P.K., E-mail: pkgoyal2002@gmail.com [Radiation and Cancer Biology Laboratory, Department of Zoology, University of Rajasthan, Jaipur (India)

    2014-07-01

    The application of radiation biology has gained greater relevance and significance in health and environmental issues. In the present time, nuclear terrorism and weapon related effects are raising much alarm and concern to public health. Obviously, radiation biology research has great potential in diagnosis, therapy and establishing standards for assessment risk from radiation exposure. The development of effective medical countermeasures against nuclear biological and chemical weapons is of immense importance to the defense of all nations and especially to those threatened by international terrorism. Chemical radiation protection is an important strategy to protect living being against deleterious effects of radiation. Earlier the synthetic chemical substances, which could minimize the pathological changes in the living system after exposure to ionizing radiation, were looked into. Medicinal plants are the local heritage with global importance. World is enclosed with a rich wealth of medicinal plants. Herbs have always been the principle form of medicine in India and presently they become popular. Over the last few years, interest in evaluating oriental medicinal herbs and edible phyto products for the use in anti-radiation strategies is encouraging and emerging as an acceptable approach for preventing the radiation induced lesions in many countries. Several Indian medicinal plants (Emblica officinalis, Rosemarinus officinalis, Trigonella foenum-graecum, Alstonia scholaris, Tinospora cordifolia, Phyllanthus niruri, Syzygium cumini, Aegle marmelos, Panax ginseng, Linum usitatissimum, Delonix regia etc) and antioxidant vitamins (C and E) have been tested in this laboratory by taking various biological end points for the possible use of natural products and phytochemicals to serve as radio protectors for medical countermeasures against radiation injuries, and the results obtained from such studies are highly encouraging and fruitful. It opens new avenues for the

  17. Prophylactic measures of radiation injuries by natural herbs and neutraceuticals

    International Nuclear Information System (INIS)

    Goyal, P.K.

    2014-01-01

    The application of radiation biology has gained greater relevance and significance in health and environmental issues. In the present time, nuclear terrorism and weapon related effects are raising much alarm and concern to public health. Obviously, radiation biology research has great potential in diagnosis, therapy and establishing standards for assessment risk from radiation exposure. The development of effective medical countermeasures against nuclear biological and chemical weapons is of immense importance to the defense of all nations and especially to those threatened by international terrorism. Chemical radiation protection is an important strategy to protect living being against deleterious effects of radiation. Earlier the synthetic chemical substances, which could minimize the pathological changes in the living system after exposure to ionizing radiation, were looked into. Medicinal plants are the local heritage with global importance. World is enclosed with a rich wealth of medicinal plants. Herbs have always been the principle form of medicine in India and presently they become popular. Over the last few years, interest in evaluating oriental medicinal herbs and edible phyto products for the use in anti-radiation strategies is encouraging and emerging as an acceptable approach for preventing the radiation induced lesions in many countries. Several Indian medicinal plants (Emblica officinalis, Rosemarinus officinalis, Trigonella foenum-graecum, Alstonia scholaris, Tinospora cordifolia, Phyllanthus niruri, Syzygium cumini, Aegle marmelos, Panax ginseng, Linum usitatissimum, Delonix regia etc) and antioxidant vitamins (C and E) have been tested in this laboratory by taking various biological end points for the possible use of natural products and phytochemicals to serve as radio protectors for medical countermeasures against radiation injuries, and the results obtained from such studies are highly encouraging and fruitful. It opens new avenues for the

  18. Endocrine factors influencing radiation injury to central nervous tissue

    International Nuclear Information System (INIS)

    Aristizabal, S.A.; Boone, M.L.; Laguna, J.F.

    1979-01-01

    Corticosteroids have been shown experimentally to lower the tolerance of various normal tissues (lung, kidney, intestine) to irradiation. Pre-existing hypertension also modified the effect of irradiation on the rat spinal cord and brain. Hypercorticism and hypertension co-exist in patients with Cushing's disease. Although these patients are often approached therapeutically by irradiation, no reports concerning differences in the radiation sensitivity of nervous tissue between normal subjects (non-functioning pituitary adenomas) and those with hormonal imbalance and/or hypertension appear to be available. A comprehensive review of the literature revealed 14 patients with radiation damage to brain or to optic pathways following moderate doses for pituitary adenomas. Seven of the 14 patients (50%) had Cushing's disease. This apparent higher incidence of radiation injury is significant if we consider that less than 5% of all patients receiving irradiation for pituitary adenomas have Cushing's disease

  19. Construction and evaluation of thoracic injury risk curves for a finite element human body model in frontal car crashes.

    Science.gov (United States)

    Mendoza-Vazquez, Manuel; Davidsson, Johan; Brolin, Karin

    2015-12-01

    There is a need to improve the protection to the thorax of occupants in frontal car crashes. Finite element human body models are a more detailed representation of humans than anthropomorphic test devices (ATDs). On the other hand, there is no clear consensus on the injury criteria and the thresholds to use with finite element human body models to predict rib fractures. The objective of this study was to establish a set of injury risk curves to predict rib fractures using a modified Total HUman Model for Safety (THUMS). Injury criteria at the global, structural and material levels were computed with a modified THUMS in matched Post Mortem Human Subjects (PMHSs) tests. Finally, the quality of each injury risk curve was determined. For the included PMHS tests and the modified THUMS, DcTHOR and shear stress were the criteria at the global and material levels that reached an acceptable quality. The injury risk curves at the structural level did not reach an acceptable quality. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Management of radiation injuries of vulva and vagina

    International Nuclear Information System (INIS)

    Fraunholz, I.B.; Schopohl, B.; Boettcher, H.D.

    1998-01-01

    Background: Acute and late injuries of vulva and vagina are frequent and potentially serious complications in radiotherapy of gynecologic tumors. They still are reported poorly in literature. Methods: Based on a literature search a survey will be given of the modalities, which are used or recommended for prophylaxis or treatment of these radiation injuries. The principles of the different measures will be discussed with available study results. Results: Hygiene measures and the topical application of antimicrobial or granulation stimulating substances, which is mostly based on long standing clinical experience, are the principles of the treatment of acute reactions of vulva and vagina. The topical use of estrogen, which promotes proliferation of epithelium, is generally described in connection with treatment and prophylaxis of late radiation injuries. As a prophylaxis for the late reaction of vaginal stenosis, vaginal dilatation is recommended in literature. Conclusion: With the exception of a few reports on estrogen, there are no data about the effectiveness of the currently used medical substances. The local application of estrogen as prophylaxis of the acute reactions will therefore be examined in a prospective study. (orig.) [de

  1. Role of sphingolipids in murine radiation-induced lung injury: protection by sphingosine 1-phosphate analogs

    Science.gov (United States)

    Mathew, Biji; Jacobson, Jeffrey R.; Berdyshev, Evgeny; Huang, Yong; Sun, Xiaoguang; Zhao, Yutong; Gerhold, Lynnette M.; Siegler, Jessica; Evenoski, Carrie; Wang, Ting; Zhou, Tong; Zaidi, Rafe; Moreno-Vinasco, Liliana; Bittman, Robert; Chen, Chin Tu; LaRiviere, Patrick J.; Sammani, Saad; Lussier, Yves A.; Dudek, Steven M.; Natarajan, Viswanathan; Weichselbaum, Ralph R.; Garcia, Joe G. N.

    2011-01-01

    Clinically significant radiation-induced lung injury (RILI) is a common toxicity in patients administered thoracic radiotherapy. Although the molecular etiology is poorly understood, we previously characterized a murine model of RILI in which alterations in lung barrier integrity surfaced as a potentially important pathobiological event and genome-wide lung gene mRNA levels identified dysregulation of sphingolipid metabolic pathway genes. We hypothesized that sphingolipid signaling components serve as modulators and novel therapeutic targets of RILI. Sphingolipid involvement in murine RILI was confirmed by radiation-induced increases in lung expression of sphingosine kinase (SphK) isoforms 1 and 2 and increases in the ratio of ceramide to sphingosine 1-phosphate (S1P) and dihydro-S1P (DHS1P) levels in plasma, bronchoalveolar lavage fluid, and lung tissue. Mice with a targeted deletion of SphK1 (SphK1−/−) or with reduced expression of S1P receptors (S1PR1+/−, S1PR2−/−, and S1PR3−/−) exhibited marked RILI susceptibility. Finally, studies of 3 potent vascular barrier-protective S1P analogs, FTY720, (S)-FTY720-phosphonate (fTyS), and SEW-2871, identified significant RILI attenuation and radiation-induced gene dysregulation by the phosphonate analog, fTyS (0.1 and 1 mg/kg i.p., 2×/wk) and to a lesser degree by SEW-2871 (1 mg/kg i.p., 2×/wk), compared with those in controls. These results support the targeting of S1P signaling as a novel therapeutic strategy in RILI.—Mathew, B., Jacobson, J. R., Berdyshev, E., Huang, Y., Sun, X., Zhao, Y., Gerhold, L. M., Siegler, J., Evenoski, C., Wang, T., Zhou, T., Zaidi, R., Moreno-Vinasco, L., Bittman, R., Chen, C. T., LaRiviere, P. J., Sammani, S., Lussier, Y. A., Dudek, S. M., Natarajan, V., Weichselbaum, R. R., Garcia, J. G. N. Role of sphingolipids in murine radiation-induced lung injury: protection by sphingosine 1-phosphate analogs. PMID:21712494

  2. Legislation and litigation related to low-level radiation injury claims

    International Nuclear Information System (INIS)

    McCraw, T.

    1985-01-01

    Current legislation and litigation related to radiation exposure will have an enormous impact on the radiation protection and monitoring requirements of the future. A brief review of some proposed injury compensation bills for veterans and a recent court decision for low-level radiation injury claims are reviewed

  3. Spontaneous Transient Lateral Thoracic Lung Herniation Resulting in Systemic Inflammatory Response Syndrome (SIRS and Subsequent Contralateral Lung Injury

    Directory of Open Access Journals (Sweden)

    Antony Kaliyadan

    2011-01-01

    Full Text Available Lung herniation is a relatively rare clinical entity that is most commonly either congenital or acquired traumatically. We describe a case of spontaneous lung herniation secondary to acute cough in an obese male smoker complicated by contralateral acute lung injury and systemic inflammatory response syndrome (SIRS. Mechanisms of lung herniation, classification, diagnosis, and management will be discussed.

  4. Development of Predictive Models of Injury for the Lower Extremity, Lumbar, and Thoracic Spine after Discharge from Physical Rehabilitation

    Science.gov (United States)

    2015-10-01

    prevention titled “Prediction, Prevention, and Preemption: Screening for sports and training injuries. What are the possibilities?” The talk was...the resources and training. The decision was made after MAJ Rhon’s PCS to BAMC, and because the site PI at Madigan there had some pregnancy

  5. Traumatic chest injury in children: A single thoracic surgeon′s experience in two Nigerian tertiary hospitals

    Directory of Open Access Journals (Sweden)

    Kelechi Emmanuel Okonta

    2015-01-01

    Full Text Available Background: This study was to determine the extent and outcome of childhood chest injury in Nigeria, and to compare results with that of other literatures. Patients and Methods: A Prospective study of all children under 18 years of age with chest trauma in two tertiary hospitals in Southern Nigeria from January 2012 to December 2014 was reviewed. The aetiology, type, associated injury, mechanism, treatment and outcome were evaluated. The patients were followed up in the clinic. The data were analysed using SPSS version 20.0 with a significant P 12-h versus 2 who presented <12-h and 6 of children between 0 and 9 years versus 3 at 10-18 years of age had empyema thoracis (P value not significant. One death was recorded. Conclusion: Chest trauma in children is still not common, and blunt chest injury from falls and automobile accidents are more common than penetrating chest injury. Treatment with tube thoracostomy is the major management modality with empyema thoracis as the most common complication.

  6. Andrographolide protects against radiation-induced lung injury in mice

    International Nuclear Information System (INIS)

    Kang Yahui; Wang Jinfeng; Zhang Qu; Huang Guanhong; Ma Jianxin; Yang Baixia; He Xiangfeng; Wang Zhongming

    2014-01-01

    Objective: To investigate the protective effect of andrographolide against radiation-induced lung injury (RILI) in C57BL/6 mice. Methods: Eighty C57BL mice were randomly divided into four groups: un-irradiated and normal saline-treated group (n = 20, control group), un-irradiated and andrographolide-treated group (n = 20, drug group), radiation plus normal saline-treated group (n = 20, radiation group) and radiation plus andrographolide-treated group (n = 20, treatment group). Before radiation, the mice in drug group and treatment group were administered daily via gavage with andrographolide (20 mg·kg -1 ·d -1 )) for 30 d, while the same volume of normal saline solution was given daily in the control and radiation groups. The model of RILI in C57BL mice was established by irradiating whole mouse chest with a single dose of 15 Gy of 6 MV X-rays. The pathological changes of the lung stained with HE/Masson were observed with a light microscope. The transforming growth factor-β1 (TGF-β1) and tumor necrosis factor-α (TNF-α) in serum were examined by enzyme-linked immunosorbent assay. The activities of malondialdehyde (MDA) and superoxide dismutase (SOD) and the content of hydroxyproline in lung tissues were examined by corresponding kits. Results: Compared with radiation group, there was an obvious amelioration in pathological injury of lung tissue in the treatment group. The lung coefficient, the activities of lung tissue MDA, the content of Hyp, the serum content of hydroxide free radical, and the serum levels of TGF-β1 and TNF-α in the treatment group were significantly lower than those in radiation group at 24 th week, (t lung coefficient = 1.60, t MDA = 7.06, t Hyp = 17.44, t TGF-β1 = 16.67, t TNF-α = 14.03, P < 0.05), while slightly higher than those in control group. The activity of SOD was significantly higher in the treatment group than that in radiation group (t = 60.81, P < 0.05), while lower than those in control group and drug group. There were no

  7. Management of radiation injuries by natural herbs and neutraceuticals

    International Nuclear Information System (INIS)

    Goyal, P.K.

    2013-01-01

    In the era of expanding nuclear energy program all over world, the role of radiation biology has acquired greater relevance and significance in addressing the health and environment issues. In view of constant human exposure to background radiation both naturally and man made e.g nuclear power plants and weapons testing, consumer products, medical X-ray, uranium mining and milling etc., the radiobiological research has been devoted to induction of cancer and evaluation of genetic effects. In the present time, nuclear terrorism and weapon related effects are raising much alarm and concern to public health. Obviously, radiation biology research has great potential in diagnosis, therapy and establishing standards for assessment risk from radiation exposure. The development of effective medical countermeasures to protect, mitigate, and treat normal tissue injury needs urgent investigation for basic molecular mechanisms and developing appropriate ready to-use kits using relevant cellular, animal model and clinical trails for practical purposes. Since the use of synthetic compounds is associated with the inherent toxicity, attention in recent years has been directed towards developing radiation countermeasure agents from the natural sources and/or nature-identical molecules. The rich biodiversity available in the Indian subcontinent has yielded several new drugs that find application in the modern medicine and there is a like hood of discovering many more, Over the last few years, interest in evaluating oriental medicinal herbs and edible phyto products for the use in anti-radiation strategies is encouraging and emerging as an acceptable approach for preventing the radiation induced lesions in many countries. Several Indian medicinal plants (Emblica officinalis, Rosemarinus officinalis, Trigonella foenum-graecum, Alstonia scholaris, Tinospora cordifolia, Phyllanthus niruri, Svzvgiumcumini, Aegle marmelos etc) and antioxidant vitamins (C and E) have been tested in this

  8. Management of radiation injuries by natural herbs and neutraceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Goyal, P.K., E-mail: pkgoyal2002@gmail.com [Radiation and Cancer Biology Laboratory, Department of Zoology, University of Rajasthan, Jaipur (India)

    2013-10-15

    In the era of expanding nuclear energy program all over world, the role of radiation biology has acquired greater relevance and significance in addressing the health and environment issues. In view of constant human exposure to background radiation both naturally and man made e.g nuclear power plants and weapons testing, consumer products, medical X-ray, uranium mining and milling etc., the radiobiological research has been devoted to induction of cancer and evaluation of genetic effects. In the present time, nuclear terrorism and weapon related effects are raising much alarm and concern to public health. Obviously, radiation biology research has great potential in diagnosis, therapy and establishing standards for assessment risk from radiation exposure. The development of effective medical countermeasures to protect, mitigate, and treat normal tissue injury needs urgent investigation for basic molecular mechanisms and developing appropriate ready to-use kits using relevant cellular, animal model and clinical trails for practical purposes. Since the use of synthetic compounds is associated with the inherent toxicity, attention in recent years has been directed towards developing radiation countermeasure agents from the natural sources and/or nature-identical molecules. The rich biodiversity available in the Indian subcontinent has yielded several new drugs that find application in the modern medicine and there is a like hood of discovering many more, Over the last few years, interest in evaluating oriental medicinal herbs and edible phyto products for the use in anti-radiation strategies is encouraging and emerging as an acceptable approach for preventing the radiation induced lesions in many countries. Several Indian medicinal plants (Emblica officinalis, Rosemarinus officinalis, Trigonella foenum-graecum, Alstonia scholaris, Tinospora cordifolia, Phyllanthus niruri, Svzvgiumcumini, Aegle marmelos etc) and antioxidant vitamins (C and E) have been tested in this

  9. Expression and significance of Bax protein in model of radiation injury in mouse skin

    International Nuclear Information System (INIS)

    Feng Yizhong; Mo Yahong

    2002-01-01

    Objective: The study is to find some valuable criteria for diagnosis and treatment of radiation injury in skin. Methods: The expression of Bax protein was studied by SP immunohistochemistry in 40 cases of model of radiation injury in mouse skin. Their relationship relating to radiation dose was also investigated. Results: The expression rates of Bax were 30%, 30%, 70%, 70% in 5 Gy group, 15 Gy group, 30 Gy group, 45 Gy group respectively. There was no significant correlation between the expression of Bax and radiation groups. Conclusions: The experiment shows that radiation can increase the expression of Bax protein which might be related to poor healing in radiation skin injury

  10. Evaluation of Partial Breast Reirradiation with Intraoperative Radiotherapy after Prior Thoracic Radiation: A Single-Institution Report of Outcomes and Toxicity

    Directory of Open Access Journals (Sweden)

    Christine Chin

    2017-08-01

    Full Text Available IntroductionMastectomy is the current standard of care for ipsilateral breast tumor recurrences after prior whole breast irradiation (WBI. We report our single-institution experience with breast-conserving surgery (BCS followed by intraoperative radiotherapy (IORT as an alternative to salvage mastectomy for new or recurrent breast cancers that develop in the setting of prior thoracic radiation.MethodsWe performed an IRB-approved retrospective review of patients treated with breast IORT between September 2013 and November 2016. We identified 12 patients who declined salvage mastectomy for their breast cancer after prior thoracic radiation. IORT was delivered using the Intrabeam™ device (Carl Zeiss, Germany. A dose of 20 Gy was prescribed to the lumpectomy cavity surface using 50 kV X-rays. We graded both acute and late treatment-related breast toxicities using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Local control, mastectomy-free survival, distant metastasis, and overall survival were determined.ResultsOur study included nine patients who developed a new or recurrent ipsilateral breast cancer after prior WBI for early-stage breast cancer, two patients with primary breast cancer after mantle-field radiation for Hodgkin’s lymphoma, and one patient with a synchronous stage III non-small cell lung cancer treated with definitive radiation to the ipsilateral lung and mediastinum. The median time from prior radiation to presentation was 18 years (range: 2 months to 46 years. All patients successfully underwent partial breast reirradiation with IORT and were able to preserve their breast. At a median follow-up of 14 months (4–25 months, there were no local or distant recurrences. There was a single non-cancer-related death. In the acute setting, we observed grade 1 toxicity in 58% (n = 7, grade 2 toxicity in 17% (n = 2, and no grade 3 or higher toxicity. In the late setting, at

  11. Changes of intermediary taurine and tryptophan metabolism after combined radiation-thermal injury

    International Nuclear Information System (INIS)

    Konnova, L.A.; Novoselova, G.S.

    1986-01-01

    The dynamics of changes of the taurine and tryptophane concentration in blood serum of rats has been studied during 30 days after 3b degree burn of 15% of body surface after total even exposure to radiation in doses of 3 and 6 Gy, and after combined radiation thermal injury. Combined radiation-thermal injury was found to be characterized by reduced concentration of taurine but an increase of the tryptophane level from the second-third day after the injury

  12. Thoracic trauma: analysis of 100 consecutive cases

    Directory of Open Access Journals (Sweden)

    Maíra Benito Scapolan

    2010-09-01

    Full Text Available Objective: To analyze thoracic trauma assisted by the EmergencyService of Hospital da Irmandade da Santa Casa de Misericórdia deSão Paulo. Methods: One hundred patients with thoracic trauma wereassisted throughout six months in 2006. Data from their records werecollected and a protocol of thoracic trauma was fulfilled. The RevisedTrauma Score was used to evaluate gravity of injury and to calculatethe survival index. Results: Prevalence of trauma injury in male from20 to 29 years old was observed. Out of all patients, 44 had blunttrauma and 56 penetrating trauma (78.6% presented stab woundsand 21.4% gun shots. Up to the settings of injuries, 23% were in thethoracoabdominal transition, 7% in the precordium and 70% in theremainder thoracic area. In those with the thoracoabdominal transitioninjury, 22.7% were hemodynamically unstable and 77.3% stable.Thoracoabdominal injury patients presented 40.9% of diaphragmwound and all were stable. Of those with precordium wound, 37.5%presented cardiac injury. In cardiac onset, 66.7% presented stableand 33.3% unstable. Thoracic drainage was the most accomplishedsurgical procedure (71%. Conclusions: The thoracic trauma patientis most prevalently young male with stab wound penetrating injury,without associated injuries, hemodynamically stable, presentinghemothorax, with high probability of survival.

  13. Surgical treatment of radiation injuries after radiotherapy for uterine carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cochrane, J P.S.; Yarnold, J R; Slack, W W [Middlesex Hospital, London (UK)

    1981-01-01

    The outcome of serious radiation injuries to the pelvic viscera in 400 patients treated by radiotherapy for carcinoma of the uterus between January 1974 and December 1978 has been reviewed. Twenty-eight instances of serious radiation damage have been found, 13 of predominantly small bowel damage, 11 of predominantly large bowel damage and 4 of bladder damage. Many patients had involvement at multiple sites. Fourteen patients have died, and 9 survivors have artificial abdominal stomas. Leaking anastomoses and progressive sepsis were major problems in the postoperative period and could be related either to inadequate resection of irradiated bowel or to damage to other organs at operation. The possibilities of earlier diagnosis and better surgical procedures are discussed.

  14. Detection of radiation induced lung injury in rats using dynamic hyperpolarized 129Xe magnetic resonance spectroscopy

    International Nuclear Information System (INIS)

    Fox, Matthew S.; Ouriadov, Alexei; Hegarty, Elaine; Thind, Kundan; Wong, Eugene; Hope, Andrew; Santyr, Giles E.

    2014-01-01

    Purpose: Radiation induced lung injury (RILI) is a common side effect for patients undergoing thoracic radiation therapy (RT). RILI can lead to temporary or permanent loss of lung function and in extreme cases, death. Combining functional lung imaging information with conventional radiation treatment plans may lead to more desirable treatment plans that reduce lung toxicity and improve the quality of life for lung cancer survivors. Magnetic Resonance Imaging of the lung following inhalation of hyperpolarized 129 Xe may provide a useful nonionizing approach for probing changes in lung function and structure associated with RILI before, during, or after RT (early and late time-points). Methods: In this study, dynamic 129 Xe MR spectroscopy was used to measure whole-lung gas transfer time constants for lung tissue and red blood cells (RBC), respectively (T Tr-tissue and T Tr-RBC ) in groups of rats at two weeks and six weeks following 14 Gy whole-lung exposure to radiation from a 60 Co source. A separate group of six healthy age-matched rats served as a control group. Results: T Tr-tissue values at two weeks post-irradiation (51.6 ± 6.8 ms) were found to be significantly elevated (p < 0.05) with respect to the healthy control group (37.2 ± 4.8 ms). T Tr-RBC did not show any significant changes between groups. T Tr-tissue was strongly correlated with T Tr-RBC in the control group (r = 0.9601 p < 0.05) and uncorrelated in the irradiated groups. Measurements of arterial partial pressure of oxygen obtained by arterial blood sampling were found to be significantly decreased (p < 0.05) in the two-week group (54.2 ± 12.3 mm Hg) compared to those from a representative control group (85.0 ± 10.0 mm Hg). Histology of a separate group of similarly irradiated animals confirmed the presence of inflammation due to radiation exposure with alveolar wall thicknesses that were significantly different (p < 0.05). At six weeks post-irradiation, T Tr-tissue returned to values (35

  15. Clinical feasibility of gait training with a robotic exoskeleton (WPAL) in an individual with both incomplete cervical and complete thoracic spinal cord injury: A case study.

    Science.gov (United States)

    Tanabe, Shigeo; Koyama, Soichiro; Saitoh, Eiichi; Hirano, Satoshi; Yatsuya, Kanan; Tsunoda, Tetsuya; Katoh, Masaki; Gotoh, Takeshi; Furumoto, Ayako

    2017-01-01

    Patients with tetraplegia can achieve independent gait with lateral-type powered exoskeletons; it is unclear whether medial-type powered exoskeletons allow for this. To investigate gait training with a medial-type powered exoskeleton wearable power-assist locomotor (WPAL) in an individual with incomplete cervical (C5) and complete thoracic (T12) spinal cord injury (SCI). The 60-session program was investigated retrospectively using medical records. Upon completion, gait performance was examined using three-dimensional motion analyses and surface electromyography (EMG) of the upper limbs. The subject achieved independent gait with WPAL and a walker in 12 sessions. He continuously extended his right elbow; his left elbow periodically flexed/extended. His pelvic inclination was larger than the trunk inclination during single-leg stance. EMG activity was increased in the left deltoid muscles during ipsilateral foot-contact. The right anterior and medial deltoid muscle EMG activity increased just after foot-off for each leg, as did the right biceps activity. Continuous activity was observed in the left triceps throughout the gait cycle; activity was unclear in the right triceps. These results suggest the importance of upper limb residual motor function, and may be useful in extending the range of clinical applications for robotic gait rehabilitation in patients with SCI.

  16. Drug/radiation interactions and central nervous system injury

    International Nuclear Information System (INIS)

    DeAngelis, L.M.; Shapiro, W.R.

    1991-01-01

    Central nervous system (CNS) injury caused by combined treatment with cranial radiation therapy (CRT) and chemotherapy is a complicated and difficult problem. Interactions between the two modalities at the cellular level, the effect of treatment sequencing, and chemotherapy and RT dosages are all poorly understood. While this is generally true and applicable to toxicities expressed in multiple organs and tissue types, it is particularly true for the brain. There are many clinical descriptions and situations that strongly implicate an enhanced neurotoxic potential for combined treatment compared to either therapy alone; there is a paucity of definitive experimental evidence, however, and few animal models that can be used to elucidate the nature and pathophysiology of this clinical association. This paper addresses the neurotoxic potential of a specific chemotherapeutic drug when combined with CRT; outlines whose drugs known to cause CNS injury when combined with CRT. Although many of the clinical situations are complicated because multiple cytotoxic agents have been used, usually only one is thought to contribute to the CNS injury. The authors discuss each drug separately

  17. Early remodeling of nasal mucosa in rat model after radiation injury

    International Nuclear Information System (INIS)

    Xiao Mang; Tang Jianguo; Luo Baozhen; Zhao Li'na; Shi Guozhi

    2008-01-01

    Objective: To explore the feature of nasal mucosa remodeling in experimental radiation injury. Methods: Fourty male rats were randomly divided into five groups, as control group and radiation injury groups (radiation dose were 20 Gy, 30 Gy, 40 Gy and 50 Gy). Each group had 8 rats. Two weeks after the last irradiation, the rats were killed and the nasal middle turbinates of the animals were removed. The tissue blocks were embedded in paraffin. The paraffin sections were stained with hematoxylin and eosin (HE), alcian blue- periodic acid-Schif (AB-PAS), and Masson Trichrome (MT). The infiltrating eosinophils in nasal mucosa were examined. AB-PAS positive cells in the surface epithelium in nasal mucosa were counted. The percentage of area in MT stained extracellular matrix in nasal mucosa and damage of epithelium were determined by an image analyzer. Results: The control group only presented a few eosinophils. Significant eosinophil infiltration was observed in the radiation injury groups, especially for the 30 Gy radiation injury group. Compared with the control group, there was no significant epithelial damage in 20 Gy radiation injury group. Significant epithelial damage were observed in the rest of radiation injury groups. The epithelial damage became more severe as the radiation dose increasing. A little but not significant increase in AB-PAS positive cells was observed in the mucos of the 20 Gy radiation injury group and significant increase in the 30 and 40 Gy groups. But in the 50 Gy radiation injury group, the AB-PAS positive cells were decreased compared with control group. The collagen fibrils in the mucosa of nasal middle turbinate in 20 Gy radiation injury group did not significantly increase.. But in the other groups, the increase was significant compared with that of control group. Furthermore, collagen fibrils increased as the radiation dose increased. Conclusions: Epithelial damage, goblet cells hyperplasia and extracellular matrix deposition are the

  18. Effects of abdominal lavage fluid from rats with radiation injury and combined radiation-burn injury on growth of hematopoietic progenitor cells

    International Nuclear Information System (INIS)

    Su, Y.-P.; Cheng, T.-M.; Guo, C.-H.; Liu, X.-H.; Qu, J.-F.

    2003-01-01

    Full text: Objective: To observe the effects of abdominal lavage fluid from rats with radiation injury, burn injury and combined radiation-burn injury on growth of hematopoietic progenitor cells. Methods Rats were irradiated with a single dose of 12 Gy γ-ray of 60Co, combined with 30% of total body surface area (TBSA) generated under a 5 KW bromo-tungsten lamp for 25 s. Lavage fluid from the peritoneum was collected 3, 12, 24, 48 and 72 hours after injury. Then the lavage fluid was added to the culture media of erythrocyte progenitor cells (CFU-E, BFE-E) or of granulocyte-macrophage progenitor cells (CFU-GM) at 40 mg/ml final concentration. Results The formed clones of CFU-E, BFU-E and CFU-GM of the lavage fluid from rats with radiation injury or combined radiation-burn injury at 3h, 12h, 24h, 48h and 72h time points were significantly higher than those from normal. They reached their peaks at 24h after injury (215.7%, 202.3%, or 241.2% from burned rats and 188.1%, 202.3% or 204.6% from rats inflected with combined radiation-burn injury as compared with those from normal rats). However, few CFU-E, BFU-E or CFU-GM clones were found after addition of lavage fluid from irradiated rats. Conclusion Peritoneal lavage fluid from rats with burn injury or combined radiation-burn injury enhances the growth of erythrocytes and granulocyte progenitor cells. On the contrary, the lavage fluid from irradiated rats shows inhibitory effects

  19. Volume effect on the radiation injury of rat kidney

    International Nuclear Information System (INIS)

    Lo, Y.-C.; Kutcher, Gerald J.; Ling, Clifton C.

    1996-01-01

    Purpose: To minimize the likelihood of radiation-induced kidney injury in treating tumors, the relationship of tolerance dose and irradiated volume of kidney should be known. We have used a rat model to determine the dose-response relationship when various volumes of the kidney are irradiated. Methods and Materials: Anesthetized adult male rats (CD, 10-12 week old) were irradiated with 250 KV x-rays. The kidney was exteriorized and placed in a jig designed to shield all other tissues. Graded single doses were delivered to each of four volumes: 1/4V (half of one kidney), 1/2V (one whole kidney, or half of each kidney), 3/4V (one and a half kidneys) and 1V, where V is the volume of both kidneys. In addition, to compare radiation injury and surgery, partial nephrectomy was performed for 1/4V, 1/2V and 3/4V. Four to sixteen rats were used for each dose-volume point. The rats have been followed up for 540 days. The endpoints for the damage were: lethality, anemia, glomerular filtration rate, effective renal flow, and histology. Results: We found that: (1) There was a threshold volume for radiation damage; injury did not occur if the volume irradiated was ≤ 1/2V, depending on the endpoints. (2) Median survival times did not depend on the dose when a small volume (i.e., 1/4V or 1/2V) was irradiated. (3) The LD 50 (and the 95% confidence limits) at 450 days were 11.35 (8.08 to 12.13) Gy for 1V, 12.38 (11.08 to 13.40) Gy for 3/4V, 21.16 (17.21 to 26.56) Gy for 1/2V, and 28.80 (21.11 to 65.00) Gy for 1/4V. (4) The ED 50 for animals with hematocrit level ≤0.36 at 365 days was 10.98 (4.96 to 13.67) Gy for 1.0V, and 13.82 (6.16 to 17.97) Gy for 3/4V. For 1/2V, only the 80% confidence limits could be derived, giving ED 50 +40.14 (27.98 to ∞) Gy. (5) The results for all other endpoints were similar to those for hematocrit. (6) The dose response was the same whether to half of each kidney or one whole kidney was irradiated. (7) While the threshold volume for radiation injury

  20. Use of combutec 2 for the treatment of patients with radiation injuries

    International Nuclear Information System (INIS)

    Selezneva, L.G.; Barabanova, A.V.; Adamyan, A.A.; Drobysh, S.V.; Kochergina, L.D.; Chechetkin, P.I.; Golovanova, N.M.; Makarova, L.R.; Tuzova, N.N.

    1991-01-01

    A high activity of combutec 2, prepared on the basis of soluble collagen, was demonstrated in patients with radiation injuries of the skin after the accident at Chernobyl. Combutec 2 can be recommended for local therapy of patients with skin radiation injuries in all periods of development of these changes

  1. Basic studies of radiation image diagnosis in veterinary medicine, 1: Comparison of the resolution of computed tomography, scanography and conventional radiography in an equine thoracic phantom

    International Nuclear Information System (INIS)

    Shida, T.; Suganuma, T.; Hashizume, T.

    1984-01-01

    In radiography of the thorax and abdomen of a large animal, the extreme thickness of the body causes a large amount of scattered radiation, which makes it difficult to obtain sharp images. The image resolutions of radiographs obtained by applying conventional radiography, scanography and computed tomography [CT] on an equine thoracic phantom were compared. Tubes of various inside diameters, used to simulate the pulmonary vessels were placed in an equine thoracic phantom and radiographed by CT, scanography and conventional radiography so as to compare the various degrees of resolution of the images of the tubes obtained by these methods. CT and scanography both gave a higher resolution index than conventional radiography, and both provided recognizable images of tubes < 2 mm in diameter, which conventional radiography failed to do. Scanography and CT can be used to obtain high-quality images of the thorax and abdomen of large animals. The image quality was compared using the resolution index (RI). The RI would be a wholly practical and comprehensive index for resolution because it includes 3 factors, contrast, sharpness and magnification, and yet is easy to calculate

  2. Prevention and Treatment of Functional and Structural Radiation Injury in the Rat Heart by Pentoxifylline and Alpha-Tocopherol

    International Nuclear Information System (INIS)

    Boerma, Marjan; Roberto, Kerrey A.; Hauer-Jensen, Martin

    2008-01-01

    Purpose: Radiation-induced heart disease (RIHD) is a severe side effect of thoracic radiotherapy. This study examined the effects of pentoxifylline (PTX) and α-tocopherol on cardiac injury in a rat model of RIHD. Methods and Materials: Male Sprague-Dawley rats received fractionated local heart irradiation with a daily dose of 9 Gy for 5 days and were observed for 6 months after irradiation. Rats were treated with a combination of PTX, 100 mg/kg/day, and α-tocopherol (20 IU/kg/day) and received these compounds either from 1 week before until 6 months after irradiation or starting 3 months after irradiation, a time point at which histopathologic changes become apparent in our model of RIHD. Results: Radiation-induced increases in left ventricular diastolic pressure (in mm Hg: 35 ± 6 after sham-irradiation, 82 ± 11 after irradiation) were significantly reduced by PTX and α-tocopherol (early treatment: 48 ± 7; late treatment: 53 ± 6). PTX and α-tocopherol significantly reduced deposition of collagen types I (radiation only: 3.5 ± 0.2 μm 2 per 100 μm 2 ; early treatment: 2.7 ± 0.8; late treatment: 2.2 ± 0.2) and III (radiation only: 13.9 ± 0.8; early treatment: 11.0 ± 1.2; late treatment: 10.6 ± 0.8). On the other hand, radiation-induced alterations in heart/body weight ratios, myocardial degeneration, left ventricular mast cell densities, and most echocardiographic parameters were not significantly altered by PTX and α-tocopherol. Conclusions: Treatment with PTX and α-tocopherol may have beneficial effects on radiation-induced myocardial fibrosis and left ventricular function, both when started before irradiation and when started later during the process of RIHD

  3. Effects of low dose radiation pretreatment on radiation injuried brain's free radicle

    International Nuclear Information System (INIS)

    Xu Fuqi; Wang Cheng; Xie Hong; Tian Ye

    2006-01-01

    Objective: To investigate the effect of low dose radiation pretreatment on radiation in- juried brain's free radicle to provide some useful data of brain radiation injury protection. Methods: One hundred mGy was selected as the pretreatment does, 25 Gy was selected as the challenge does. Experiment rats were divided into three groups randomly, group one as simple group:the group irradiated without exposing to pre-irradiation; group two as 6 h-group: the group irradiated with LDR pretreatment 6 h before exposing to 25 Gy irradiation; group three as 24 h-group:the group irradiated with LDR pretreatment 24 h before 25 Gy irradiation. The observation was done 6 hour's after irradiation, the effect of LDR pretreatment on increasing activity of the superoxide dismutase(SOD) and the content of malondialdehyde(MDA) after the brain tissue homogenate were detected. Results: Com- pared with the simple group, the group with LDR pretreatment showed increasing of SOD and decreasing of MDA at the 6th hour after 25Gy irradiation. In addition, there was no difference between the 6 h-group and the 24 h-group. Conclusion: LDR pretreatment can increase SOD and decrease MDA in some period. It could infer that the suitable LDR pretreatment could play a protective role in the brain radiation injury. (authors)

  4. Radiated-induced brain injury: advance of molecular mechanisms and neuroprotection strategies

    International Nuclear Information System (INIS)

    Gao Bo; Wang Xuejian

    2007-01-01

    The underlying mechanisms of radiated-induced brain injury (RBI) remain incompletely clear. Pathophysiological data indicate that the development of RBI involves complex and dynamic interactions between neurons, glia, and vascular endothelial cells within thecentral nervous system (CNS). Radiated-induced injury in the CNS can be modulated by the therapies directed at altering steps in the cascade of events leading to the clinical expression of normal tissue injury. Some neuroprotective strategies are also addressed in the review. (authors)

  5. Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated with Radiotherapy

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-15-1-0681 TITLE: Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated with Radiotherapy PRINCIPAL...TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-1-0681Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated...effects, urinary morbidity, rectal injury, sexual dysfunction 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF

  6. Radiation pancreatic death. A new radiation injury and its pathologic physiology

    Energy Technology Data Exchange (ETDEWEB)

    Tsubouchi, Susumu [Fukui Medical School, Fukui (Japan)

    1982-03-01

    In lethal radiation injury, the organ which is responsible for gastrointestinal death was sought from the relationship between radiation dose and survival length of hamsters. In this research, a new plateau was found in the range of radiation dose from 30,000 to 60,000 rad. Histological examination revealed that the organ responsible to the survival of the animals in the plateau was Langerhans's (L.'s) island of the pancreas. Acute necrotic changes of L.'s islands was disclosed by blood glucose level, changes in granules of ..cap alpha.. and ..beta.. cells, atrophy of L.'s islands, and by deficiency of blood insulin. The death of hamsters in the plateau is probably due to diabetic syndrome which was induced by the necrosis of L.'s island.

  7. Radiation diagnosis of pelvic ring damages in acute injury

    International Nuclear Information System (INIS)

    Dytalov, M.M.

    2000-01-01

    Data on 58 victims with multifocal damages to the pelvic ring were used to examine the diagnostic potentialities of different radiation diagnostic techniques and to compare their resolving power. The later was 65.1, 83.3 and 94.7% in plain and multidimensional X-ray studies, and computed tomography, respectively. Complex of signs is described closed sacral fractures on the plain and oblique pelvic inlet (caudal) radiograms proposed, which could improve the diagnosis of fractures by 8.8 times, and an original orthopedic gauze-plate for the detection and estimation of invisible pelvic bone displacement, and an original procedure for pelvic X-ray study with target load in acute injury. This all can improve the quality of examination of casualties substantially and define indications for different treatments more precise [ru

  8. The validity of compliance monitors to assess wearing time of thoracic-lumbar-sacral orthoses in children with spinal cord injury.

    Science.gov (United States)

    Hunter, Louis N; Sison-Williamson, Mitell; Mendoza, Melissa M; McDonald, Craig M; Molitor, Fred; Mulcahey, M J; Betz, Randal R; Vogel, Lawrence C; Bagley, Anita

    2008-06-15

    Prospective multicenter observation. To determine the validity of 3 commercially available at recording thoracic-lumbar-sacral orthosis (TLSO) wearing time of children with spinal cord injury (SCI) and to assess each monitor's function during daily activities. A major limitation to studies assessing the effectiveness of spinal prophylactic bracing is the patient's compliance with the prescribed wearing time. Although some studies have begun to use objective compliance monitors, there is little documentation of the validity of the monitors during activities of daily life and no comparisons of available monitors. Fifteen children with SCI who wore a TLSO for paralytic scoliosis were observed for 4 days during their rehabilitation stay. Three compliance monitors (2 temperature and 1 pressure sensitive) were mounted onto each TLSO. Time of brace wear from the monitors was compared with the wear time per day recorded in diaries. Observed versus monitored duration of brace wear found the HOBO (temperature sensitive) to be the most valid compliance monitor. The HOBO had the lowest average of difference and variance of difference scores. The correlation between the recorded daily entries and monitored brace wear time was also highest for the HOBO in analysis of dependent and independent scores. Bland-Altman plots showed that the pressure sensitive monitor underestimated wear time whereas the temperature monitors overestimated wear time. Compliance to prescribed wearing schedule has been a barrier to studying TLSO efficacy. All 3 monitors were found to measure TLSO compliance, but the 2 temperature monitors were more in agreement with the daily diaries. Based on its functional advantages compared with the HOBO, the StowAway TidbiT will be used to further investigate the long-term compliance of TLSO bracing in children with SCI.

  9. Accelerated split-course (Type B) thoracic radiation therapy plus vinorelbine/carboplatin combination chemotherapy in Stage III inoperable non-small cell lung cancer

    International Nuclear Information System (INIS)

    Iaffaioli, R.V.; Tortoriello, A.; Facchini, G.; Maccauro, M.; Dimitri, P.; Ravo, V.; Muto, P.; Crovella, F.

    1996-01-01

    43 patients with stage III NSCLC (non-small cell lung cancer) entered a phase II study aimed at evaluating the toxicity and the activity of a combined modality programme including an accelerated split-course schedule (type B) of thoracic radiation therapy and a combination chemotherapy with vinorelbine and carboplatin. An objective response was achieved in 18/42 evaluable patients (5 complete and 13 partial responses), for an overall response rate of 43% (95% confidence interval, 28-58%). Four complete responses had a duration which exceeded 16 months. Treatment was well tolerated; grade III myelotoxicity occurred in only 14% of patients and treatment was delayed in only 2 cases because of grade 3 oesophagitis. Both tolerability and efficacy data suggest that this regimen holds promise for the treatment of patients with stage III NSCLC. (author)

  10. Capacity of bone marrow colony forming unit-fibroblasts in vitro from mice with combined radiation-burn injury

    International Nuclear Information System (INIS)

    Chen Xinghua; Luo Chengji; Guo Chaohua; Wang Ping

    1999-01-01

    Objective: To investigate the capacity of bone marrow colony forming unit-fibroblasts (CFU-F) from mice with combined radiation-burn injury. Methods: Mice were treated with 5.0 Gy γ-ray radiation alone, 15% total body surface area (TBSA) III degree burn alone or combined radiation-burn. The numbers of CFU-Fs were assayed by Dexter's method. Results: The numbers of CFU-Fs from mice with radiation and combined radiation-burn injury were significantly decreased, compared with those of controls and mice with burn injury alone (P<0.05-0.01). conclusion: The results reveal that the repairing process of bone marrow stromal cells from mice with radiation injury and combined radiation-burn injury is slow, and the combined radiation-burn injury inflicted on the stromal cells possesses the characteristic of radiation injury

  11. Mitotic delay of irradiated cells and its connection with quantity of radiation injuries

    International Nuclear Information System (INIS)

    Lobachevskij, P.N.; Fominykh, E.V.

    1989-01-01

    The study is dedicated to development of mathematical approach to interpret radiation-induced mitosic delay. An assumption is made that mitotic delay is conditioned by discrete injuries distributed in cells according to stochasticity of interaction of radiation and target substance. It is supposed to consider the problem on injuries nature causing mitotic delay and to use the developed method for accounting the effect of radiation-induced mitotic delay on registered chromosomal aberration yield. 10 refs.; 2 figs.; 3 tabs

  12. Pilot study of human recombinant interferon gamma and accelerated hyperfractionated thoracic radiation therapy in patients with unresectable stage IIIA/B nonsmall cell lung cancer

    International Nuclear Information System (INIS)

    Shaw, Edward G.; Deming, Richard L.; Creagan, Edward T.; Nair, Suresh; Su, John Q.; Levitt, Ralph; Steen, Preston D.; Wiesenfeld, Martin; Mailliard, James A.

    1995-01-01

    Purpose: Gamma interferon has a wide range of properties, including the ability to sensitize solid tumor cells to the effects of ionizing radiation. The North Central Cancer Treatment Group has previously completed pilot studies of accelerated hyperfractionated thoracic radiation therapy (AHTRT) in patients with unresectable Stage IIIA/B nonsmall cell lung cancer (NSCLC). This Phase I study was designed to assess the toxicity of concomitant gamma interferon and AHTRT in a similar patient population. Methods and Materials: Between December 1991 and May 1992, 18 patients with unresectable Stage IIIA/B NSCLC were treated with daily gamma interferon (0.2 mg subcutaneously) concomitant with AHTRT (60 Gy given in 1.5 Gy twice daily fractions). All patients had an Eastern Cooperative Oncology Group performance status of 0 or 1 with weight loss < 5%. Eight patients had Stage IIIA and 10 had Stage IIIB disease. Results: Nine patients (50%) experienced severe, life-threatening, or fatal toxicities. Eight of the patients (44%) developed significant radiation pneumonitis, which was severe in six patients and fatal in two patients (11% treatment-related mortality). Two patients (11%) developed severe radiation esophagitis. With follow-up of 15-21 months, 2 patients are alive, and 16 have died. The median survival time and 1-year survival rate is 7.8 months and 38%, respectively. Conclusion: Gamma interferon appeared to sensitize normal lung tissue to the effects of radiation, as demonstrated by the high incidence of severe or fatal radiation pneumonitis. We do not recommend pursuing gamma interferon as a radiosensitizer in this setting

  13. Lithium stimulates the recovery of granulopoiesis following acute radiation injury.

    Science.gov (United States)

    Gallicchio, V S; Chen, M G; Watts, T D; Gamba-Vitalo, C

    1983-07-01

    Lithium (Li) is a known stimulator of steady-state granulopoiesis, influencing both pluripotential (CFUS) and granulocyte-macrophage committed stem cell (CFUGM) populations. Li has therefore been suggested to be an effective agent to reduce the neutropenia that often is seen after either cytotoxic chemotherapy or radiotherapy protocols. In this report, we have examined bone marrow and spleen cells for their recovery patterns of CFUS, CFUGM, CFUE, BFUE and 59Fe-incorporation, along with the usual peripheral blood indices (packed red cell volume, WBC and differential) from mice administered Li after receiving 200 rad whole body irradiation. Li increased granulopoietic recovery as measured by significant elevations in both marrow and spleen derived CFUGM compared to those values obtained from radiation controls. Significant elevation in the WBC, consisting mainly of neutrophils, was also observed. Bone marrow and splenic derived erythroid stem cells (CFUE, BFUE) and % 59Fe-incorporation measured from peripheral blood, femur and spleen were all slightly reduced, but not to a significant degree to alter the packed red cell volume. The CFUS populations from both irradiated groups (control and Li-treated) were depressed when compared to normal non-irr controls and this degree of suppression was greater in the Li-treated group. These results document the ability of Li to stimulate the recovery of granulopoiesis after radiation-induced hematopoietic injury and suggest Li may be useful in ameliorating the neutropenia that can often develop after routine radiotherapy protocols.

  14. Lithium stimulates the recovery of granulopoiesis following acute radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Gallicchio, V.S.; Chen, M.G.; Watts, T.D.; Gamba-Vitalo, C.

    1983-07-01

    Lithium (Li) is a known stimulator of steady-state granulopoiesis, influencing both pluripotential (CFUS) and granulocyte-macrophage committed stem cell (CFUGM) populations. Li has therefore been suggested to be an effective agent to reduce the neutropenia that often is seen after either cytotoxic chemotherapy or radiotherapy protocols. In this report, bone marrow and spleen cells have been examined for their recovery patterns of CFUS, CFUGM, CFUE, BFUE and 59Fe-incorporation, along with the usual peripheral blood indices (packed red cell volume, WBC and differential) from mice administered Li after receiving 200 rad whole body irradiation. Li increased granulopoietic recovery as measured by significant elevations in both marrow and spleen derived CFUGM compared to those values obtained from radiation controls. Significant elevation in the WBC, consisting mainly of neutrophils, was also observed. Bone marrow and splenic derived erythroid stem cells (CFUE, BFUE) and % 59Fe-incorporation measured from peripheral blood, femur and spleen were all slightly reduced, but not to a significant degree to alter the packed red cell volume. The CFUS populations from both irradiated groups (control and Li-treated) were depressed when compared to normal non-irradiated controls and this degree of suppression was greater in the Li-treated group. These results document the ability of Li to stimulate the recovery of granulopoiesis after radiation-induced hematopoietic injury and suggest Li may be useful in ameliorating the neutropenia that can often develop after routine radiotherapy protocols.

  15. Radiation-induced hypoxia may perpetuate late normal tissue injury

    International Nuclear Information System (INIS)

    Vujaskovic, Zeljko; Anscher, Mitchell S.; Feng, Q.-F.; Rabbani, Zahid N.; Amin, Khalid; Samulski, Thaddeus S.; Dewhirst, Mark W.; Haroon, Zishan A.

    2001-01-01

    Purpose: The purpose of this study was to determine whether or not hypoxia develops in rat lung tissue after radiation. Methods and Materials: Fisher-344 rats were irradiated to the right hemithorax using a single dose of 28 Gy. Pulmonary function was assessed by measuring the changes in respiratory rate every 2 weeks, for 6 months after irradiation. The hypoxia marker was administered 3 h before euthanasia. The tissues were harvested at 6 weeks and 6 months after irradiation and processed for immunohistochemistry. Results: A moderate hypoxia was detected in the rat lungs at 6 weeks after irradiation, before the onset of functional or histopathologic changes. The more severe hypoxia, that developed at the later time points (6 months) after irradiation, was associated with a significant increase in macrophage activity, collagen deposition, lung fibrosis, and elevation in the respiratory rate. Immunohistochemistry studies revealed an increase in TGF-β, VEGF, and CD-31 endothelial cell marker, suggesting a hypoxia-mediated activation of the profibrinogenic and proangiogenic pathways. Conclusion: A new paradigm of radiation-induced lung injury should consider postradiation hypoxia to be an important contributing factor mediating a continuous production of a number of inflammatory and fibrogenic cytokines

  16. Protective effect of plant polysaccharides against radiation injury

    International Nuclear Information System (INIS)

    Wang Bingji; Huang Shafei; Cheng Lurong

    1989-01-01

    A series of polysaccharides have been isolated from Chinese traditional medicinal herbs and tested in mice subjected to ionizing radiation for their protective action. The polysaccharides from different origins showed various degrees of radioprotection. Those isolated from Hericium erinaceus and Armillaria mellea showed a higher radioprotective effect than some other polysaccharides. They could increase the survival rate of irradiated mice to 60%. But the polysaccheride separated from Apocynum venetum has negligible effect. In general, most of these polysaccharides are effective only on administration before irradiation. No apparent protection was observed when given post irradiation. The polysaccharide isolated from Armillaria venetum could raise the survival rate of mice irradiated by lethal dose of γ-rays to 58%. It is effective even when administered after irradiation. Some work has been carried out to clarify the mechanism of radioprotective action of polysaccharides. Protection of hemapoietic organs, regulation of immunological system, induction of release of some endogeneous bioactive substances in the organism and reduction of oxygen tension in some vital tissues may be correlated with the protection of organism against radiation injury

  17. Understanding of radiation protection in medicine. Pt. 1. Knowledge about radiation exposure and anxiety about radiation injury

    International Nuclear Information System (INIS)

    Iida, Hiroji; Yamamoto, Tomoyuki; Shimada, Yasuhiro

    1997-01-01

    Using a questionnaire we investigated whether radiation exposure in correctly understood by medical doctors (n=140), nurses (n=496) and the general public (n=236). Thirty-three percent of medical doctors, 53% of nurses and the general public did not know who is legally allowed to irradiate the human body. Forty-five percent of doctors, 63% of nurses and 48% of the general public complained of anxiety about radiation injury. Fifty-six percent of patients did not ask medical doctors or nurses for an explanation of the risk of exposure. Moreover, 64% of doctors did not explain the risk to patients. In addition, 21% of doctors, 46% of nurses and the general public incorrectly understood that x-rays remain in the examination room. Twenty-seven percent of doctors, 49% of nurses and 80% of the general public did not know the t en-day rule . In conclusion, the results of this questionnaire indicated that basic knowledge about radiation exposure was not adequate. To protect against medical radiation exposure, personnel who are licensed to irradiate to the human body should be well recognized by medical staff and the general public. It is also important that informed consent for radiological examinations be based on fundamental knowledge about radiation exposure. Therefore, to reach a general consensus on radiological examinations and to reduce individual exposure, general public education regarding radiation protection is required. Postgraduate education on radiation protection for medical doctors and nurses is also strongly recommended. (author)

  18. Mental and growth retardation after medulloblastoma radiation therapy. MRI assessment of radiation injuries

    International Nuclear Information System (INIS)

    Miyagi, Koichi; Mukawa, Jiro; Mekaru, Susumu; Harakuni, Tsuyoshi; Yamaguchi, Keiichiro; Tominaga, Daisuke; Nakasone, Susumu.

    1996-01-01

    We report on 3 cases of a medulloblastoma and discuss the usefulness of calculating the T2 value from long-term follow-up MRIs of 1.5 T in order to analyze the cause of mental retardation. Of 13 medulloblastoma patients who were treated at our hospital from 1970 through 1984, 4 patients survived. Excluding 1 of these patients, a 2-year-old child, the remaining 3 cases are discussed. The 3 patients underwent surgery and received postoperative craniospinal irradiation and chemotherapy. The radiation dose (tumoral dose) was 40 to 85 Gy to the posterior fossa, 0 to 30.4 Gy to the spinal cord, and 25.6 to 35.2 Gy to the whole brain. The long-term effects were evaluated by calculating the T2 value and conducting a psychometric analysis from 2 to 11 years after radiation therapy. Their respective Tanaka-Vineland IQ test results were 32, 46, and 102 and their respective growth heights were -3.6 SD, -6.4 SD, and +0.18 SD. Growth hormone deficiencies were identified in all 3 patients. The decline in ability and failure to grow became more pronounced with time. The calculated T2 values showed alterations in the hippocampus, the occipital white matter, and the hypothalamus of all 3 patients. The hippocampal alteration contributed to a decline in intellectual ability and resulted in learning difficulties at school. It should be noted that in addition to whole-brain radiation that was pursued, the focal radiation provided delivers the same radiation dose to the hippocampus as to the tumor. Such a high radiation dose thus might be responsible for the decline in intellectual ability. Therefore, to avoid radiation injury to these areas, stereotactic radiosurgery must be planned for focal radiation therapy. (K.H.)

  19. Imaging of rare radiation injuries after radiosurgery for brain metastases

    International Nuclear Information System (INIS)

    Yamanaka, Kazuhiro; Yoshimura, Masaki; Iwai, Yoshiyasu

    2011-01-01

    Gamma knife radiosurgery (GKS) is generally an effective and safe treatment for brain metastases. We report 3 rare complicated cases after GKS due to radiation injury including image findings. Case 1: A 58-year-old man received whole brain radiation therapy for right occipital brain metastasis from lung cancer. However, local recurrence was noted and GKS was carried out 5 months later (size 28 mm, marginal dose 23 Gy (50% isodose)). Four years later, a cyst appeared and the patient developed apraxia and visual disturbance. Surgery was performed and the histopathology showed necrosis. Case 2: A 51-year-old woman received GKS for 4 brain metastases from breast cancer. The right occipital lobe lesion was treated with marginal dose of 18 Gy (size 24 mm, 50% isodose). Thirty-one months later, she developed left homonymous hemianopsia and MR imaging and CT scan showed intracerebral hemorrhage with cyst formation. An operation was performed and the histology revealed necrosis. Case 3: A 37-year-old man received GKS for left temporal brain metastasis from lung cancer (size 14 mm, marginal dose 23 Gy (50% isodose)). Twelve months later, the lesion increased in size again, so we carried out a second GKS on the same lesion (size 15 mm, marginal dose 23 Gy (50% isodose)). Thirty-five months later, massive peritumoral edema appeared and the patient developed left oculomotor palsy. An emergency operation was performed and the histopathological diagnosis was cavernous malformation that was thought to be induced by radiosurgery. Although the incidence is low, rare complications associated with radiation therapy can also occur by radiosurgery. (author)

  20. Radiation-Induced Skin Injuries to Patients: What the Interventional Radiologist Needs to Know.

    Science.gov (United States)

    Jaschke, Werner; Schmuth, Matthias; Trianni, Annalisa; Bartal, Gabriel

    2017-08-01

    For a long time, radiation-induced skin injuries were only encountered in patients undergoing radiation therapy. In diagnostic radiology, radiation exposures of patients causing skin injuries were extremely rare. The introduction of fast multislice CT scanners and fluoroscopically guided interventions (FGI) changed the situation. Both methods carry the risk of excessive high doses to the skin of patients resulting in skin injuries. In the early nineties, several reports of epilation and skin injuries following CT brain perfusion studies were published. During the same time, several papers reported skin injuries following FGI, especially after percutaneous coronary interventions and neuroembolisations. Thus, CT and FGI are of major concern regarding radiation safety since both methods can apply doses to patients exceeding 5 Gy (National Council on Radiation Protection and Measurements threshold for substantial radiation dose level). This paper reviews the problem of skin injuries observed after FGI. Also, some practical advices are given how to effectively avoid skin injuries. In addition, guidelines are discussed how to deal with patients who were exposed to a potentially dangerous radiation skin dose during medically justified interventional procedures.

  1. A Contralateral Esophagus-Sparing Technique to Limit Severe Esophagitis Associated With Concurrent High-Dose Radiation and Chemotherapy in Patients With Thoracic Malignancies

    International Nuclear Information System (INIS)

    Al-Halabi, Hani; Paetzold, Peter; Sharp, Gregory C.; Olsen, Christine; Willers, Henning

    2015-01-01

    Purpose: Severe (Radiation Therapy Oncology Group [RTOG] grade 3 or greater) esophagitis generally occurs in 15% to 25% of non–small cell lung cancer (NSCLC) patients undergoing concurrent chemotherapy and radiation therapy (CCRT), which may result in treatment breaks that compromise local tumor control and pose a barrier to dose escalation. Here, we report a novel contralateral esophagus-sparing technique (CEST) that uses intensity modulated radiation therapy (IMRT) to reduce the incidence of severe esophagitis. Methods and Materials: We reviewed consecutive patients with thoracic malignancies undergoing curative CCRT in whom CEST was used. The esophageal wall contralateral (CE) to the tumor was contoured as an avoidance structure, and IMRT was used to guide a rapid dose falloff gradient beyond the target volume in close proximity to the esophagus. Esophagitis was recorded based on the RTOG acute toxicity grading system. Results: We identified 20 consecutive patients treated with CCRT of at least 63 Gy in whom there was gross tumor within 1 cm of the esophagus. The median radiation dose was 70.2 Gy (range, 63-72.15 Gy). In all patients, ≥99% of the planning and internal target volumes was covered by ≥90% and 100% of prescription dose, respectively. Strikingly, no patient experienced grade ≥3 esophagitis (95% confidence limits, 0%-16%) despite the high total doses delivered. The median maximum dose, V45, and V55 of the CE were 60.7 Gy, 2.1 cc, and 0.4 cc, respectively, indicating effective esophagus cross-section sparing by CEST. Conclusion: We report a simple yet effective method to avoid exposing the entire esophagus cross-section to high doses. By using proposed CE dose constraints of V45 <2.5 cc and V55 <0.5 cc, CEST may improve the esophagus toxicity profile in thoracic cancer patients receiving CCRT even at doses above the standard 60- to 63-Gy levels. Prospective testing of CEST is warranted

  2. Chest x-ray as a screening tool for blunt thoracic trauma in children.

    Science.gov (United States)

    Yanchar, Natalie L; Woo, Kenneth; Brennan, Maureen; Palmer, Cameron S; Zs Ee, Michael; Sweeney, Brian; Crameri, Joe

    2013-10-01

    With the increasing use of thoracic computed tomography (CT) to screen for injuries in pediatric blunt thoracic trauma (BTT), we determined whether chest x-ray (CXR) and other clinical and epidemiologic variables could be used to predict significant thoracic injuries, to inform the selective use of CT in pediatric BTT. We further queried if these were discrepant from factors associated with the decision to obtain a thoracic CT. This retrospective cohort study included cases of BTT from three Level I pediatric trauma centers between April 1999 and March 2008. Pre-CT epidemiologic, clinical, and radiologic variables associated with CT findings of any thoracic injury or a significant thoracic injury as well as the decision to obtain a thoracic CT were determined using logistic regression. Of 425 patients, 40% patients had a significant thoracic injury, 49% had nonsignificant thoracic injury, and 11% had no thoracic injury at all. Presence of hydrothorax and/or pneumothorax on CXR significantly increased the likelihood of significant chest injury visualized by CT (adjusted odds ratio 10.8; 95% confidence interval, 6.5-18), as did the presence of isolated subcutaneous emphysema (adjusted odds ratio, 19.8; 95% confidence interval, 2.3-168). Although a normal CXR finding was not statistically associated with a reduced risk of significant thoracic injury, 8 of the 9 cases with normal CXR findings and significant injuries involved occult pneumothoraces or hemothoraces not requiring intervention. Converse to features suggesting increased risk of significant injury, the decision to obtain a thoracic CT was only associated with later period in the study and obtaining a CT scan of another body region. CXR can be used to screen for significant thoracic injuries and direct the selective use of thoracic CT in pediatric BTT. Prospective studies are needed to validate these findings and develop guidelines that include CXR to define indications for thoracic CT in pediatric BTT

  3. Early structural changes in sheep lung following thoracic irradiation

    International Nuclear Information System (INIS)

    Guerry-Force, M.L.; Perkett, E.A.; Brigham, K.L.; Meyrick, B.

    1988-01-01

    Using a large animal model of radiation lung injury--the sheep exposed to bilateral thoracic irradiation--we have recently shown the development of sustained pulmonary hypertension during the first 4 weeks following radiation. This is the period prior to the onset of pneumonitis and pulmonary fibrosis. In the present study, we have examined biopsy and autopsy lung tissue from these same sheep and assessed the sequential changes in lung morphology. Six unanesthetized sheep received bilateral thoracic irradiation (a total of 15 Gy); control sheep were sham irradiated. Lung biopsy tissue was taken prior to and at weekly or biweekly intervals during the 4 weeks immediately following radiation. The lungs were also removed at autopsy for light and electron microscopic examination. Our results show early (Week 1) interstitial and progressive intraalveolar edema accompanied by endothelial and epithelial injury. A gradual increase in number of interstitial mononuclear cells was evident from Week 1, both in the lung tissue and in perivascular cuffs. The number of peripheral lung interstitial mononuclear cells was twice baseline from Week 3 and included accumulation of lymphocytes, fibroblasts, and intravascular macrophages. The increased numbers of mononuclear cells paralleled the development of chronic pulmonary hypertension, perhaps suggesting their involvement in the pathogenesis of this disease. Alternatively, it may be that increased mononuclear cell number represents a stage of lung repair

  4. Age peculiarities of postraumatic repair of open fractures in case of combined radiation injuries

    International Nuclear Information System (INIS)

    Shantyr', V.I.; Korzh, A.A.; Frenkel', L.A.; Kazitskij, V.M.; Lan'ko, A.I.; Yakovenko, M.G.

    1982-01-01

    Results of investigation of recovery in rabbit soft tissues (skin, muscle tissue) and in bones following bone fractures and whole-body X-irradiation are presented. Heavier damages developed in connective tissue in adolescent than in adult rabbits in conditions of combined radiation injuries. Normalization of connective tissue in skin and muscles was observed by 90 day in adolescent rabbits, where as connective tissue remained inferior in adult animals. Bone tissue recovery remained unfinished by 90 day in adolescent and adult rabbits in conditions of combined radiation injuries. The main reason for slowing-down of recovery of damaged tissues in case of open fracture is radiation injury in the irradiated organism

  5. Thoracic CT in the ED: a study of thoracic computed tomography utilisation.

    LENUS (Irish Health Repository)

    Williams, E

    2010-02-01

    The aim of this retrospective study was to investigate the use of thoracic Computed Tomography (CT) in the Emergency Department of a Dublin Academic Teaching Hospital over a six month period. Data was retrieved using the hospital\\'s computerised information system. There were 202 referrals in total for thoracic CT from the Emergency Department during this time period. The most common indication for thoracic CT referral was for the investigation of pulmonary embolism with 127 (63%) referrals. There were 40 (25%) referrals for suspected malignancy and lung disease, whilst 8 (4%) of the referrals were for investigation of thoracic aortic dissection, 8 (4%) for infection, and 6 (3%) were for investigation of thoracic injury. Only 8 (4%) of all referrals were for investigation of injury as a result of chest trauma.

  6. Therapy of combined radiation injuries with hemopoietic growth factors

    International Nuclear Information System (INIS)

    Boudagov, R.; Oulianova, L.

    1996-01-01

    Radiation accidents of the 5-7 th levels according to IAEA scale lead to life-threatening acute radiation syndrome and many patients will probably suffer from additional thermal burns. These combined injuries (CI) will be among the most difficult to achieve survival. Present therapeutic means need to augment with new approaches to stimulate host defence mechanisms, blood system recovery and to enhance survival. The evaluation of therapeutic properties of human recombinant G-CSF, IL-1,IL-2 and other so called 'biological response modifiers' on survival and blood recovery after CI was the purpose of this work. Experiments carried out with mice CBA x C57BL6 receiving 7 Gy total body irradiation followed by a full-thickness thermal bum of 10% of body surface. It established that G-CSF does not exhibit a positive modifying action on the damage level and on hematopoietic recovery. I.p two-four/fold infusion of IL-2 during the initial 2 days has provided a significant statistically survival increase from 40% (untreated mice with CI) to 86%. Single s.c IL-1 injection resulted in abrupt deterioration of the outcome when dealing with CI; three/fold administration of IL-1 in 2,4 and 6 days after CI did not increase survival. Extracellular yeast polysaccharides resulted only a 15 to 30% increase in survival it given 1 h after CI. The best results obtained when mixture of heat-killed L.acidophilus injected s.c immediately alter CI - survival has increased from 27% (untreated mice) to 80%. Revealed beneficial effects of IL-2 and biological response modifiers did not accompany by a corresponding correction of depressed hematological parameters

  7. Inhibition of intestinal epithelial apoptosis improves survival in a murine model of radiation combined injury.

    Directory of Open Access Journals (Sweden)

    Enjae Jung

    Full Text Available World conditions place large populations at risk from ionizing radiation (IR from detonation of dirty bombs or nuclear devices. In a subgroup of patients, ionizing radiation exposure would be followed by a secondary infection. The effects of radiation combined injury are potentially more lethal than either insult in isolation. The purpose of this study was to determine mechanisms of mortality and possible therapeutic targets in radiation combined injury. Mice were exposed to IR with 2.5 Gray (Gy followed four days later by intratracheal methicillin-resistant Staphylococcus aureus (MRSA. While either IR or MRSA alone yielded 100% survival, animals with radiation combined injury had 53% survival (p = 0.01. Compared to IR or MRSA alone, mice with radiation combined injury had increased gut apoptosis, local and systemic bacterial burden, decreased splenic CD4 T cells, CD8 T cells, B cells, NK cells, and dendritic cells, and increased BAL and systemic IL-6 and G-CSF. In contrast, radiation combined injury did not alter lymphocyte apoptosis, pulmonary injury, or intestinal proliferation compared to IR or MRSA alone. In light of the synergistic increase in gut apoptosis following radiation combined injury, transgenic mice that overexpress Bcl-2 in their intestine and wild type mice were subjected to IR followed by MRSA. Bcl-2 mice had decreased gut apoptosis and improved survival compared to WT mice (92% vs. 42%; p<0.01. These data demonstrate that radiation combined injury results in significantly higher mortality than could be predicted based upon either IR or MRSA infection alone, and that preventing gut apoptosis may be a potential therapeutic target.

  8. Inhibition of intestinal epithelial apoptosis improves survival in a murine model of radiation combined injury.

    Science.gov (United States)

    Jung, Enjae; Perrone, Erin E; Brahmamdan, Pavan; McDonough, Jacquelyn S; Leathersich, Ann M; Dominguez, Jessica A; Clark, Andrew T; Fox, Amy C; Dunne, W Michael; Hotchkiss, Richard S; Coopersmith, Craig M

    2013-01-01

    World conditions place large populations at risk from ionizing radiation (IR) from detonation of dirty bombs or nuclear devices. In a subgroup of patients, ionizing radiation exposure would be followed by a secondary infection. The effects of radiation combined injury are potentially more lethal than either insult in isolation. The purpose of this study was to determine mechanisms of mortality and possible therapeutic targets in radiation combined injury. Mice were exposed to IR with 2.5 Gray (Gy) followed four days later by intratracheal methicillin-resistant Staphylococcus aureus (MRSA). While either IR or MRSA alone yielded 100% survival, animals with radiation combined injury had 53% survival (p = 0.01). Compared to IR or MRSA alone, mice with radiation combined injury had increased gut apoptosis, local and systemic bacterial burden, decreased splenic CD4 T cells, CD8 T cells, B cells, NK cells, and dendritic cells, and increased BAL and systemic IL-6 and G-CSF. In contrast, radiation combined injury did not alter lymphocyte apoptosis, pulmonary injury, or intestinal proliferation compared to IR or MRSA alone. In light of the synergistic increase in gut apoptosis following radiation combined injury, transgenic mice that overexpress Bcl-2 in their intestine and wild type mice were subjected to IR followed by MRSA. Bcl-2 mice had decreased gut apoptosis and improved survival compared to WT mice (92% vs. 42%; p<0.01). These data demonstrate that radiation combined injury results in significantly higher mortality than could be predicted based upon either IR or MRSA infection alone, and that preventing gut apoptosis may be a potential therapeutic target.

  9. Thoracic damage control surgery.

    Science.gov (United States)

    Gonçalves, Roberto; Saad, Roberto

    2016-01-01

    The damage control surgery came up with the philosophy of applying essential maneuvers to control bleeding and abdominal contamination in trauma patients who are within the limits of their physiological reserves. This concept was extended to thoracic injuries, where relatively simple maneuvers can shorten operative time of in extremis patients. This article aims to revise the various damage control techniques in thoracic organs that must be known to the surgeon engaged in emergency care. RESUMO A cirurgia de controle de danos surgiu com a filosofia de se aplicar manobras essenciais para controle de sangramento e contaminação abdominal, em doentes traumatizados, nos limites de suas reservas fisiológicas. Este conceito se estendeu para as lesões torácicas, onde manobras relativamente simples, podem abreviar o tempo operatório de doentes in extremis. Este artigo tem como objetivo, revisar as diversas técnicas de controle de dano em órgãos torácicos, que devem ser de conhecimento do cirurgião que atua na emergência.

  10. Factors affecting radiation injury after interstitial brachytherapy for brain tumors

    International Nuclear Information System (INIS)

    Leibel, S.A.; Gutin, P.H.; Davis, R.L.

    1991-01-01

    The effects of brachytherapy on normal brain tissue are not easily delineated in the clinical setting because of the presence of concurrent radiation-induced changes in the coexistent brain tumor. Sequential morphologic studies performed after the implantation of radioactive sources into the brains of experimental animals have provided a better understanding of the character and magnitude of the structural changes produced by interstitial irradiation on normal brain tissue. Furthermore, the clinical experience accumulated thus far provides not only relevant information, but also some guidelines for future treatment policies. In this paper, the authors summarize the experimental findings and review the pathologic and clinical features of brain injury caused by interstitial brachytherapy. A number of studies in the older literature examined the effects of radioisotopes such as radium-226 (38--43), radon-22 (44--46), gold-198 (29,47--50), tantalum-182 (29,51,52) yttrium-9- (50,53,54), and cobalt-60 (29,50,55). This review is restricted to low- and high-activity encapsulated iodine-125 ( 125 I) and iridium-192 ( 192 Ir), the isotopes that are most commonly used in current clinical practice

  11. Clinical and experimental investigation on small intestinal injury following radiation therapy for carcinoma of uterine cervix

    International Nuclear Information System (INIS)

    Asakura, Midori

    1977-01-01

    Radiation injury of the small bowel was observed in 6 of 460 patients with carcinoma of uterine cervix who were treated by radiation between April 1966 and December 1973 at Tokyo Women's Medical College, Department of Radiology. Three of these 6 patients were treated conservatively and the other 3 others underwent surgery but died subsequently. Clinically and surgically these 6 patients showed marked adhesions of intestinal loops, which may be accounted for by the radiation injury of the small bowel. Clinical experience has shown that it is necessary to use a small radiation field to decrease small bowel injury from radiation. An experiment using abdominal radiation in mice confirmed that LD sub(50/30) is larger with a center split, maintaining equal integral doses. In adult dogs, severe small bowel obstruction was observed with over 4000 rad irradiation. Small bowel injury was milder in case with center split, intracavitary irradiation, and small radiation field. It was concluded that center split is one of the methods of preventing radiation injury of the small bowel. (Evans, J.)

  12. Pediatric thoracic CT angiography at 70 kV: a phantom study to investigate the effects on image quality and radiation dose

    International Nuclear Information System (INIS)

    MacDougall, Robert D.; Kleinman, Patricia L.; Lee, Edward Y.; Yu, Lifeng

    2016-01-01

    Studies have demonstrated that 70-kilovolt (kV) imaging enhances the contrast of iodine, potentially affording a reduction in radiation dose while maintaining the contrast-to-noise ratio (CNR). There is a maximum amount of image noise beyond which increased contrast does not improve structure visualization. Thus, noise should be constrained during protocol optimization. This phantom study investigated the effect of 70-kV imaging for pediatric thoracic CT angiography on image quality and radiation dose in a pediatric population when a noise constraint was considered. We measured contrast and noise using anthropomorphic thoracic phantoms ranging in size from newborn age equivalent to 10-year-old age equivalent. We inserted contrast rods into the phantoms to simulate injected contrast material used in a CT angiography study. The image-quality metric ''iodine CNR with a noise constraint'' was used to determine the relative dose factor for each phantom size, kV setting (70-140 kV) and noise constraint (1.00-1.20). A noise constraint of 1.20 indicates that noise should not increase by more than 20% of the noise level in images performed at the reference kV, selected to be 80 kV in this study. The relative dose factor can be applied to the original dose obtained at 80 kV in order to maintain iodine CNR with the noise constraint. A relative dose factor <1.0 indicates potential for dose reduction while a relative dose factor >1.0 indicates a dose penalty. Iodine contrast was highest for 70 kV and decreased with higher kV settings for all phantom sizes. The relative dose factor at 70 kV was <1.0 for all noise constraint >1.0, indicating potential for dose reduction, for the newborn, 1-year-old and 5-year-old age-equivalent phantom sizes. For the 10-year-old age-equivalent phantom, relative dose factor at 70 kV=1.22, 1.11, 1.01, 0.92 and 0.83 for noise constraint=1.00, 1.05, 1.10, 1.15, 1.20, respectively, indicating a dose penalty for noise constraint

  13. Comminuted fracture of the thoracic spine.

    LENUS (Irish Health Repository)

    Cashman, J P

    2012-02-03

    BACKGROUND: Road deaths fell initially after the introduction of the penalty points but despite this, the rate of spinal injuries remained unchanged. AIMS: We report a patient with a dramatic spinal injury, though without neurological deficit. We discuss the classification, management and economic impact of these injuries. METHODS: We describe the management of a patient with a comminuted thoracic spinal fracture without neurological injury. We conducted a literature review with regard to the availability of literature of the management of these injuries. RESULTS: This 17-year-old female was managed surgically and had a good functional outcome. There is no clear consensus in the published literature on the management of these injuries. CONCLUSIONS: Comminuted thoracic spinal factures are potentially devastating. Such a patient presents challenges in determining the appropriate treatment.

  14. [Experimental model of severe local radiation injuries of the skin after X-rays].

    Science.gov (United States)

    Kotenko, K V; Moroz, B B; Nasonova, T A; Dobrynina, O A; LIpengolz, A A; Gimadova, T I; Deshevoy, Yu B; Lebedev, V G; Lyrschikova, A V; Eremin, I I

    2013-01-01

    The experimental model of severe local radiation injuries skin under the influence of a relatively soft X-rays on a modified device RAP 100-10 produced by "Diagnostica-M" (Russia) was proposed. The model can be used as pre-clinical studies in small experimental animals in order to improve the treatment of local radiation injuries, especially in the conditions of application of cellular therapy.

  15. Efficiency of early application of immunomodulators in combined effect of radiation and thermal injury

    International Nuclear Information System (INIS)

    Makarov, G.F.

    1989-01-01

    Medical effect of thymus preparations (thymoline, thymoptine) and levamysole under combined radiation-thermal injury is studied. Experimental results have shown that early application of certain immunostimulators under combined radiation-thermal injury of medium criticality is low-efficient. Their ability to sufficiently increase the antibody synthesis is manifested only under combined action of burns and irradiation in non-lethal doses. 5 refs

  16. Comparison of Thoracic Injury Risk in Frontal Car Crashes for Occupant Restrained without Belt Load Limiters and Those Restrained with 6 kN and 4 kN Belt Load Limiters.

    Science.gov (United States)

    Foret-Bruno, J Y; Trosseille, X; Page, Y; Huère, J F; Le Coz, J Y; Bendjellal, F; Diboine, A; Phalempin, T; Villeforceix, D; Baudrit, P; Guillemot, H; Coltat, J C

    2001-11-01

    In France, as in other countries, accident research studies show that a large proportion of restrained occupants who sustain severe or fatal injuries are involved in frontal impacts (65% and 50%, respectively). In severe frontal impacts with restrained occupants and where intrusion is not preponderant, the oldest occupants very often sustain severe thoracic injuries due to the conventional seat belt. As we have been observing over the last years, we will expect in the coming years developments which include more solidly-built cars, as offset crash test procedures are widely used to evaluate the passive safety of production vehicles. The reduction of intrusion for the most severe frontal impacts, through optimization of car deformation, usually translates into an increase in restraint forces and hence thoracic injury risk with a conventional retractor seat belt for a given impact severity. It is, therefore essential to limit the restraint forces exerted by the seat belt on the thorax in order to reduce the number of road casualties. In order to address thoracic injury risk in frontal impact, Renault cars have been equipped with the Programmed Restraint System (PRS) since 1995. The PRS is a restraint system that combines belt load limitation and pyrotechnic belt pretension. In an initial design of the Programmed Restraint System (PRS1), the belt load limiter was a steel component designed to shear at a given shoulder force, namely 6 kN. It was mounted between the retractor and the lower anchorage point of the belt. The design of the PRS was modified in 1998 (PRS2), but the principle of load limitation was maintained. The threshold was decreased to 4 kN and this lower belt belt-force limiter has been combined with a specially designed airbag. This paper reports on 347 real-world frontal accidents where the EES (Equivalent Energy Speed) ranged from 35 to 75 km/h. One hundred and ninety-eight (198) of these accidents involved cars equipped with the 6 kN load limiter

  17. Radiation myelopathy

    International Nuclear Information System (INIS)

    Berlit, P.

    1987-01-01

    After a review of the world literature, the case histories of 43 patients with radiation myelopathy are analyzed. In 1 patient there was a radiation injury of the medulla oblongata, in 2, cervical, in 28, thoracic, and in 12, lumbosacral. In the medulla oblongata lesion an alternans syndrome resulted. The patients with cervical and thoracic radiation myelopathies presented with a Brown-Sequard syndrome, a spinalis anterior syndrome or a transversal syndrome with pyramidal and spinothalamic tract involvement as the most prominent signs. For this group the term 'pyramidal-spinothalamic radiation myelopathy' is proposed. In lumbosacral radiation lesions a pure anterior horn syndrome may lead to spinothalamic tract involvement and the development of a cauda conus syndrome. The clinical presentation of these cases suggests that the location of the radiation lesion is most likely the region of the conus medullaris. The most frequent initial symptom was dysesthesia; the patients complained of burning pain or a feeling of coldness. Usually the neurological deficits were progressive, in pyramidal-spinothalamic radiation myelopathy over 12 months in average, in lumbosacral radiation lesions up to 10 years. The latent period between the finish of radiation therapy and the first neurological signs was 8 months (median) in cervical and thoracic myelopathy and 33 months in lumbosacral lesions. For the entire group of 43 patients there was an inverse relationship between the radiation dose (ret) and the latent period. A positive relation could be demonstrated between the age of patients at the time of radiation therapy and the latent period. Patients simultaneously receiving cytostatic drugs presented after a longer latent period than the remaining group. (orig./MG)

  18. Use of ethonium in the treatment of late radiation injuries of the skin, radiation cystitis and rectitis

    International Nuclear Information System (INIS)

    Bardychev, M.S.; Kurpesheva, A.K.; Petrik, V.D.

    1979-01-01

    Conducted has been investigation of therapeutic effectiveness of ethonium in 71 patients of late radiation injuries of the skin, urinary bladder and rectum. Local radiation injuries developed after radiotherapy of malignant tumours. Shown is comparatively low effectiveness of application of 0.5-2 % aqueous solutions and 2 % ethonium ointment in the expressed necrotic-inflammatory process in radiation ulcer of skin and its expressed effectiveness at granulating late radiation ulcers of skin. Application of 0.02-0.05 % ethonium solution in the form of microclusters and suppositories of 0.05 g of the preparation proved to be effective at catarrhal rectitis and rectosigmoids. An attempt to treat radiation cyctitis aroused aggravation of the inflammatory process of the mucous membrane off the ucinary bladder

  19. Histomorphologic change of radiation pneumonitis in rat lungs: captopril reduces rat lung injury induced by irradiation

    International Nuclear Information System (INIS)

    Kim, Jin Hee

    1999-01-01

    To assess the histomorphologic changes in the rat lung injury induced by radiation, to determine whether captopril reduces the rat lung injury and to evaluate change in TNF-α and TGF β and rat lung damage by radiation and captopril. Right lungs in male Sprague-Dawley rats were divided irradiation alone (10, 20, 30 Gy) or radiation (same dose with radiation alone group) with captopril (500 mg/L). Radiation alone group were sacrificed at twelve hours and eleven weeks after radiation and radiation with captopril group (captopril group) were sacrificed at eleven weeks after radiation with captopril. We examined the light microscope and electron microscopic features in the groups. In radiation alone group, there were patch parenchymal collapse and consolidation at twelve hours after radiation. The increase of radiation dose shows more prominent the severity and broader the affected areas. Eleven weeks after radiation, the severity and areas of fibrosis had increased in proportion to radiation dose given in the radiation alone group. There was notable decrease of lung fibrosis in captopril group than in radiation alone group. The number of mast cells rapidly increased with increase of radiation dose in radiation alone group and the degree of increase of mast cell number and severity of collagen accumulation more decreased in captopril group than in radiation alone group. In radiation alone group expression of TNF-α and TGF-β] increased according to increase of radiation dose at twelve hours after radiation in both group. At eleven weeks after radiation, expression of TGF- P increased according to increase of radiation dose in radiation group but somewhat decreased in captopril group. In the captopril group the collagen deposition increased but less dense than those of radiation alone group. The severity of perivascular thickening, capillary change, the number and degranulation of mast cells more decreased in the captopril group than in the radiation alone group. It

  20. Molecular analysis of radiation injury in rat taste buds

    International Nuclear Information System (INIS)

    Nakagawa, K.; Abe, K.

    2003-01-01

    Full text: A critical adverse effect of radiation therapy for head and neck cancer is the resulting decreased sense of taste, which greatly impairs patients' quality of life. Irradiation of the head and neck area decreases the sense of taste within one or two weeks and recovery takes about one month. Although taste bud cells are intimately involved in these manifestations, few basic studies in this area have been reported. Here, we investigate the injury and recovery process of taste bud tissue after irradiation, at the molecular and cellular levels. Rat tongues were selectively irradiated once with 15 Gy of 6 MV X-rays. Immediately thereafter and at periods up to 30 days samples were collected for HE staining, BrdU labelling, p21 and p53 immunohistochemistry, and TUNEL staining. Six days after irradiation, morphologically-identified taste bud cells, as well as the surrounding epithelial tissue, were no longer visible. Immature bud cells reappeared ten days after irradiation, and looked morphologically normal at 13 to 15 days.BrdU labelling revealed DNA synthesis arrest in of epithelial cells 10 days after irradiation. Cells in the basal layer expressed p21 four hours after irradiation. Prior to that, it, p53 accumulation was observed in the nucleus. Expression of p21 was no longer detectable by on the sixth day or later, and DNA synthesis resumed around the eighth day. No apoptosis was detected at any time. The disappearance and reappearance of taste bud cells after a single 15-Gy irradiation dose can be explained by temporary cell cycle arrest in taste bud stem cells, which is regulated by p21

  1. Preventive effect of Chinese traditional medicine-Qing-Xue granula on radiation induced lung injury in mice

    International Nuclear Information System (INIS)

    Wang Xiaozhen; Ji Wei; Jiang Heng; Zhao Lujun; Yang Weizhi; Yang Yufei; Wang Luhua

    2012-01-01

    Objective: To evaluate whether oral administration of Chinese traditional medicine, Qing-Xue granula, can prevent mouse lung injury caused by thoracic radiation. Methods: 128 BalB/C mice were divided into 4 groups: control (C) group; radiation (R) group; radiation plus high dose Qing-Xue granula (H) group and radiation plus median dose Qing-Xue granula (M) group. The H and M groups were fed 0.64 g and 0.32 g of Qing-Xue granula dissolved in 0.5 ml saline once daily for two months,which were 4 and 2 times of human dosage, respectively. Whole thorax radiation of 12 Gy was delivered with a single ventral-dorsal field with 6 MV X-ray. Group C and group R received 21 days of 0.5 ml saline feeding. Mice were sacrificed at 1, 2, 4 or 6 months after radiation. Macrophage cell count of lung lavage fluid and hydroxyproline content of left lung were assayed, and the lung fibrosis was scored according to the Ashcroft's criteria. The plasma interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) concentration were assayed with ELISA method. The One-way ANOVA was used to test the significance of any differences between groups at each time point. Results: The macrophage cell number of lung lavage fluid was significantly lower in the 1 st month in group M than in group R (2:4, q =3.92, P 0.05). The hydroxyproline content of group H was significantly lower than group R in the 1 st and 6 th months (q =3.62, 3.54, all P nd , 4 th and 6 th months (q=3.38 -4.16, all P st month (q=3.53, P 0.05). The VEGF concentration was significantly higher in group R than group C since the 2 nd month (q =3.12 - 3.78, P nd and 6 th months (q =3.08 - 3.92, all P<0.05). Conclusions: Oral Chinese traditional medicine, Qing-Xue granula, could prevent radiation induced lung fibrosis in mice, especially at high dosage. The degree of elevation of VEGF in plasma was not parallel with that of lung fibrosis. (authors)

  2. Changes of some immune functions in combined radiation-burn injury in rats

    International Nuclear Information System (INIS)

    Yan Yongtang; Ran Xinze; Wei Shuqing

    1991-01-01

    The characteristics of some immune functions in radiation injury (6 Gy), burn injury (15%, III deg) and combined radiation-burn injury (CRBI) were studied in rats. The results showed that the functions of splenocytes and thymocytes in radiation injury group (RIG) were depressed more markedly 24-72 h after injury. The degree of thymocyte depression in burn injury group (BIG) was significantly lower than that in RIG and recovered more easily. The characteristics of the CRBI effects were as follows: (1) The combined depression effect on thymocytes in CRBI as compared with that in RIG was deeper and the recovery was slower. (2) The depression course of splenocytes was similar to that in RIG, but the depression degree in the early stage was significantly more heavy than that in RIG. (3) In the later stage of CRBI the level of recovery of T H cells was significantly lower than that in RIG. (4) Eschar-excision plus skin grafting at 24 h after combined injury was helpful for the recovery of thymocyte and splenocytes function. The results showed that the depression and recovery of immune functions in combined injury were closely related to the wound of burn

  3. Capabilities for Clinical Management of Radiation Injuries of the Nikiforov Russian Center of Emergency and Radiation Medicine (EMERCOM of Russia)

    International Nuclear Information System (INIS)

    Aleksanin, S.

    2016-01-01

    This article presents an overview of the capabilities for clinical management of radiation injuries available at the Nikiforov Russian Center of Emergency and Radiation Medicine (NRCERM) of the Ministry of the Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters (EMERCOM). NRCERM is a federal state budgetary institution and the Russian Federation's head organization for providing medical assistance for persons overexposed to ionizing radiation, responders to radiation emergencies and people evacuated from radiation contaminated areas. As the WHO Collaborating Center for Treatment and Rehabilitation of Accident Recovery Workers of Nuclear and Other Disasters and a member of the WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN), NRCERM is prepared to provide assistance and technical support in case of a radiation accident. For this purpose, NRCERM hospitals are equipped with technologically advanced facilities and possess well-trained specialist staff. (authors)

  4. Patient's quality of life after high-dose radiation therapy for thoracic carcinomas. Changes over time and influence on clinical outcome

    International Nuclear Information System (INIS)

    Schroeder, Christina; Engenhart-Cabillic, Rita; Vorwerk, Hilke; Schmidt, Michael; Huhnt, Winfried; Blank, Eyck; Sidow, Dietrich; Buchali, Andre

    2017-01-01

    Quality of life (QoL) is an important factor in patient care. This analysis is focused on QoL before and after radio(chemo)therapy in patients with thoracic carcinomas, as well as on its influence on clinical follow-up and survival, and the correlation with treatment-related toxicities. The analysis included 81 patients with intrathoracic carcinoma receiving radio(chemo)therapy. For analysis of QoL, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the lung cancer-specific supplement (EORTC QLQ-LC13) were used. QoL data were collected before radiation treatment (RT), and 6 weeks, 12 weeks, 6 months, and 12 months after RT. Other factors were additionally analyzed, including clinical outcome, survival, and side effects. The functional scales showed maximum values or at least a recovery 12 weeks after RT. Symptoms with a high mean symptom score (> 40) at all appointments were fatigue, dyspnea, and coughing. Insomnia, peripheral neuropathy, appetite loss, dyspnea (from QLQ-LC13), and all pain parameters had an intermediate mean score (10-40). There were low mean scores of < 10 for nausea and vomiting, diarrhea, sore mouth, and hemoptysis. There was a significant correlation between clinical dysphagia and radiation pneumonitis with the associated symptom scales. None of the QoL scores had a significant influence on local and distant control or survival. 12 weeks after RT the QLQ-C30 functional scales show the highest scores or at least a temporary recovery. The symptom scales accurately reflect the common symptoms and treatment-related toxicities. QoL did not prove to be a significant predictor for local and distant control or survival. (orig.) [de

  5. Combination of Radiation and Burn Injury Alters FDG Uptake in Mice

    Science.gov (United States)

    Carter, Edward A.; Winter, David; Tolman, Crystal; Paul, Kasie; Hamrahi, Victoria; Tompkins, Ronald; Fischman, Alan J.

    2012-01-01

    Radiation exposure and burn injury have both been shown to alter glucose utilization in vivo. The present study was designed to study the effect of burn injury combined with radiation exposure, on glucose metabolism in mice using [18F] Fluorodeoxyglucose (18FDG). Groups of male mice weighing approximately 30g were studied. Group 1 was irradiated with a 137Cs source (9 Gy). Group 2 received full thickness burn injury on 25% total body surface area followed by resuscitated with saline (2mL, IP). Group 3 received radiation followed 10 minutes later by burn injury. Group 4 were sham treated controls. After treatment, the mice were fasted for 23 hours and then injected (IV) with 50 µCi of 18FDG. One hour post injection, the mice were sacrificed and biodistribution was measured. Positive blood cultures were observed in all groups of animals compared to the shams. Increased mortality was observed after 6 days in the burn plus radiated group as compared to the other groups. Radiation and burn treatments separately or in combination produced major changes in 18FDG uptake by many tissues. In the heart, brown adipose tissue (BAT) and spleen, radiation plus burn produced a much greater increase (p<0.0001) in 18FDG accumulation than either treatment separately. All three treatments produced moderate decreases in 18FDG accumulation (p<0.01) in the brain and gonads. Burn injury, but not irradiation, increased 18FDG accumulation in skeletal muscle; however the combination of burn plus radiation decreased 18FDG accumulation in skeletal muscle. This model may be useful for understanding the effects of burns + irradiation injury on glucose metabolism and in developing treatments for victims of injuries produced by the combination of burn plus irradiation. PMID:23143615

  6. Radioprotectors effect on the efficiency of combined treatment of radiation injuries (review of the literature)

    International Nuclear Information System (INIS)

    Farshatov, M.N.

    1986-01-01

    Therapeutic efficiency of radioprotector action (cystamine, in particular) under isolated and combined (in combination with burns, mechanical injuries of skull, brain, limbs internal organs etc.) radiation affection is discussed on the basis of experiment data, obtained by different authors. The conclusion is drawn, that under combined radiation affections with leading radial component, radioprotectors provide for approximately the same protection effect as under isolated radioactive irradiation by a corresponding dose. In combination with radial and nonradial injury means they can sufficiently reduce lethality and create better conditions for favourable course of burn deseases and mechanical injuries. It is pointed out, that preliminary protection gains decisive value in cases, when under combined radiation affection the radial component prevails. In this case radiosensitive tissue protection becomes necessary condition for the victim's life preservation, complication frequency reduction and improvement of treatment results. Advisability of inclusion of medical protection means into the step-by-step treatment system, wile foreseeing both isolated and combined radiation affections, is shown

  7. The effect of the diazepam to the free radical under the brain radiation injury

    International Nuclear Information System (INIS)

    Huo Hongmei; Wang Chen; Zhang Zhilin

    2007-01-01

    Objective: To study the effect of the diazepam on free radical under in the brain radiation injury in the early stage. Methods: A model of whole brain radiation injury in wakefulness was established in the Sprague-Dawley rat. Diazepam was given intraperitoneally 30 minutes before radiation. The brain tissue homogenate was prepared respectively while the rats were executed 6 hours, 1 day, 1 week, 1 month after irradiation. The contents of the superoxide dismutase (SOD) and the malondialdehyde (MDA) in the tissue homogenate were measured by chemical colorimetry. Results: Diazepam could increase the vigor of SOD and reduce the MDA contents after irradiated. Conclusions: Diazepam has certain neuroprotection effect on radiation injury and decreasing the level of the free radicals. (authors)

  8. Asphyxiating thoracic dysplasia

    International Nuclear Information System (INIS)

    Franzcr, J.; Kozlowski, K.

    2008-01-01

    Asphyxiating Thoracic Dysplasia is the most frequent form of Small Thorax - Short Rib Syndromes. Asphyxiating Thoracic Dysplasia in two patients with different clinical course is reported. Radiographic examination is the only method to diagnose Asphyxiating Thoracic Dysplasia with certainty. The correct diagnosis is important for prognostication and genetic counseling. It also excludes the necessity of further, often expensive investigations. (author)

  9. Technical Note: Thoracic duct embolization for treatment of chylothorax: A novel guidance technique for puncture using combined MRI and fluoroscopy

    International Nuclear Information System (INIS)

    Praveen, Alampath; Sreekumar, Karumathil Pullara; Nazar, Puthukudiyil Kader; Moorthy, Srikanth

    2012-01-01

    Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct

  10. Technical Note: Thoracic duct embolization for treatment of chylothorax: A novel guidance technique for puncture using combined MRI and fluoroscopy.

    Science.gov (United States)

    Praveen, Alampath; Sreekumar, Karumathil Pullara; Nazar, Puthukudiyil Kader; Moorthy, Srikanth

    2012-04-01

    Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct.

  11. Phase 2 Study of Accelerated Hypofractionated Thoracic Radiation Therapy and Concurrent Chemotherapy in Patients With Limited-Stage Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Xia, Bing [Department of Radiation Oncology, Shanghai Cancer Center, Fudan University, Shanghai (China); Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou (China); Hong, Ling-Zhi [Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing (China); Cai, Xu-Wei; Zhu, Zheng-Fei; Liu, Qi; Zhao, Kuai-Le; Fan, Min; Mao, Jing-Fang; Yang, Huan-Jun; Wu, Kai-Liang [Department of Radiation Oncology, Shanghai Cancer Center, Fudan University, Shanghai (China); Fu, Xiao-Long, E-mail: xlfu1964@hotmail.com [Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai (China)

    2015-03-01

    Purpose: To prospectively investigate the efficacy and toxicity of accelerated hypofractionated thoracic radiation therapy (HypoTRT) combined with concurrent chemotherapy in the treatment of limited-stage small-cell lung cancer (LS-SCLC), with the hypothesis that both high radiation dose and short radiation time are important in this setting. Methods and Materials: Patients with previously untreated LS-SCLC, Eastern Cooperative Oncology Group performance status of 0 to 2, and adequate organ function were eligible. HypoTRT of 55 Gy at 2.5 Gy per fraction over 30 days was given on the first day of the second or third cycle of chemotherapy. An etoposide/cisplatin regimen was given to 4 to 6 cycles. Patients who had a good response to initial treatment were offered prophylactic cranial irradiation. The primary endpoint was the 2-year progression-free survival rate. Results: Fifty-nine patients were enrolled from July 2007 through February 2012 (median age, 58 years; 86% male). The 2-year progression-free survival rate was 49.0% (95% confidence interval [CI] 35.3%-62.7%). Median survival time was 28.5 months (95% CI 9.0-48.0 months); the 2-year overall survival rate was 58.2% (95% CI 44.5%-71.9%). The 2-year local control rate was 76.4% (95% CI 63.7%-89.1%). The severe hematologic toxicities (grade 3 or 4) were leukopenia (32%), neutropenia (25%), and thrombocytopenia (15%). Acute esophagitis and pneumonitis of grade ≥3 occurred in 25% and 10% of the patients, respectively. Thirty-eight patients (64%) received prophylactic cranial irradiation. Conclusion: Our study showed that HypoTRT of 55 Gy at 2.5 Gy per fraction daily concurrently with etoposide/cisplatin chemotherapy has favorable survival and acceptable toxicity. This radiation schedule deserves further investigation in LS-SCLC.

  12. The use dibunol therapy for radiation injuries of the skin and mucous membranes

    International Nuclear Information System (INIS)

    Agafonova, G.B.; Barsel', V.A.; Sarkisyan, Yu.Kh.; Terekhova, G.S.; Podlyashchuk, E.L.; Ustinova, V.F.; AN SSSR, Moscow. Inst. Khimicheskoj Fiziki)

    1983-01-01

    There are presented the results of the use of dibunol in the form of liniment (1-10%) for the treatment of radiation cystitis and rectitis resulting from radiation therapy of small pelvic tumors, epidermitis and epithelitis that develop in the course of treatment of skin and lower lip tumors. A high efficacy of the drug in the therapy of radiation injury has been shown in 212 patients

  13. Use dibunol therapy for radiation injuries of the skin and mucous membranes

    Energy Technology Data Exchange (ETDEWEB)

    Agafonova, G.B.; Barsel' , V.A.; Sarkisyan, Yu.Kh.; Terekhova, G.S.; Podlyashchuk, E.L.; Ustinova, V.F. (Nauchno-Issledovatel' skij Inst. Rentgenologii i Radiologii, Moscow (USSR); AN SSSR, Moscow. Inst. Khimicheskoj Fiziki)

    1983-04-01

    There are presented the results of the use of dibunol in the form of liniment (1-10%) for the treatment of radiation cystitis and rectitis resulting from radiation therapy of small pelvic tumors, epidermitis and epithelitis that develop in the course of treatment of skin and lower lip tumors. A high efficacy of the drug in the therapy of radiation injury has been shown in 212 patients.

  14. Gustatory tissue injury in man: radiation dose response relationships and mechanisms of taste loss

    International Nuclear Information System (INIS)

    Mossman, K.L.

    1986-01-01

    In this report dose response data for gustatory tissue damage in patients given total radiation doses ranging from 3000 to 6000 cGy are presented. In order to evaluate direct radiation injury to gustatory tissues as a mechanism of taste loss, measurements of damage to specific taste structures in bovine and murine systems following radiation exposure in the clinical range are correlated to taste impairment observed in radiotherapy patients. (author)

  15. Pathophysiological Responses in Rat and Mouse Models of Radiation-Induced Brain Injury.

    Science.gov (United States)

    Yang, Lianhong; Yang, Jianhua; Li, Guoqian; Li, Yi; Wu, Rong; Cheng, Jinping; Tang, Yamei

    2017-03-01

    The brain is the major dose-limiting organ in patients undergoing radiotherapy for assorted conditions. Radiation-induced brain injury is common and mainly occurs in patients receiving radiotherapy for malignant head and neck tumors, arteriovenous malformations, or lung cancer-derived brain metastases. Nevertheless, the underlying mechanisms of radiation-induced brain injury are largely unknown. Although many treatment strategies are employed for affected individuals, the effects remain suboptimal. Accordingly, animal models are extremely important for elucidating pathogenic radiation-associated mechanisms and for developing more efficacious therapies. So far, models employing various animal species with different radiation dosages and fractions have been introduced to investigate the prevention, mechanisms, early detection, and management of radiation-induced brain injury. However, these models all have limitations, and none are widely accepted. This review summarizes the animal models currently set forth for studies of radiation-induced brain injury, especially rat and mouse, as well as radiation dosages, dose fractionation, and secondary pathophysiological responses.

  16. In vivo evidence for an endothelium-dependent mechanism in radiation-induced normal tissue injury

    Science.gov (United States)

    Rannou, Emilie; François, Agnès; Toullec, Aurore; Guipaud, Olivier; Buard, Valérie; Tarlet, Georges; Mintet, Elodie; Jaillet, Cyprien; Iruela-Arispe, Maria Luisa; Benderitter, Marc; Sabourin, Jean-Christophe; Milliat, Fabien

    2015-01-01

    The pathophysiological mechanism involved in side effects of radiation therapy, and especially the role of the endothelium remains unclear. Previous results showed that plasminogen activator inhibitor-type 1 (PAI-1) contributes to radiation-induced intestinal injury and suggested that this role could be driven by an endothelium-dependent mechanism. We investigated whether endothelial-specific PAI-1 deletion could affect radiation-induced intestinal injury. We created a mouse model with a specific deletion of PAI-1 in the endothelium (PAI-1KOendo) by a Cre-LoxP system. In a model of radiation enteropathy, survival and intestinal radiation injury were followed as well as intestinal gene transcriptional profile and inflammatory cells intestinal infiltration. Irradiated PAI-1KOendo mice exhibited increased survival, reduced acute enteritis severity and attenuated late fibrosis compared with irradiated PAI-1flx/flx mice. Double E-cadherin/TUNEL labeling confirmed a reduced epithelial cell apoptosis in irradiated PAI-1KOendo. High-throughput gene expression combined with bioinformatic analyses revealed a putative involvement of macrophages. We observed a decrease in CD68+cells in irradiated intestinal tissues from PAI-1KOendo mice as well as modifications associated with M1/M2 polarization. This work shows that PAI-1 plays a role in radiation-induced intestinal injury by an endothelium-dependent mechanism and demonstrates in vivo that the endothelium is directly involved in the progression of radiation-induced enteritis. PMID:26510580

  17. Attenuative effects of G-CSF in radiation induced intestinal injury

    International Nuclear Information System (INIS)

    Kim, Joong Sun; Gong, Eun Ji; Kim, Sung Dae; Heo, Kyu; Ryoo, Seung Bum; Yang, Kwang Mo

    2011-01-01

    Granulocyte colony stimulating factor (G-CSF) has been reported to protect from radiationinduced myelosuppression. Growing evidence suggests that G-CSF also has many important non-hematopoietic functions in other tissues, including the intestine (Kim et al., 2010; Kim et al., 2011). However, little is known about the influence of G-CSF on intestinal injury. Examination 12 hours after radiation (5 Gy) revealed that the G-CSF treated mice were significantly protected from apoptosis of jejunal crypt, compared with radiation controls. G-CSF treatment attenuated intestinal morphological changes such as decreased survival crypt, the number of villi, villous shortening, crypt depth and length of basal lamina of 10 enterocytes compared with the radiation control 3.5 days after radiation (10 Gy). G-CSF attenuated the change of peripheral blood from radiation-induced myelosuppression and displayed attenuation of mortality in lethally-irradiated (10 Gy) mice. The present results support the suggestion that G-CSF administrated prior to radiation plays an important role in the survival of irradiated mice, possibly due to the protection of hematopoietic cells and intestinal stem cells against radiation. The results indicate that G-CSF protects from radiation-mediated intestinal damage and from hematopoietic injury. G-CSF treatment may be useful clinically in the prevention of injury following radiation.

  18. Treatment of radiation burns, 1987 [videorecording][Radiation injuries following an accident at a nuclear power plant, 1986. Medical aspects of Chernobyl, 1986

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1987-07-01

    After the accident at Chernobyl, patients with various degrees of radiation burns were given treatment at Moscow hospital No. 6. The video shows the radiation injuries as well as therapy and treatment in detail.

  19. Lung pathology in case of acute radiation injury

    International Nuclear Information System (INIS)

    Vlasov, P.A.; Kvacheva, Yu.V.

    1998-01-01

    Results of pathomorphological studies of 27 patients exposed to total external γ- and β-radiation resulted from the Chernobyl accident and lost due to the acute radiation disease in the first weeks following radiation exposure are discussed. Dose range is 3.7-13.7 Gy. Two groups of pathological changes in lungs are revealed, those are: infection (bacterial, viral and fungous) ones caused by acute radiation disease and signs of respiratory distress-syndrome in adults [ru

  20. Thoracic trauma: presentation and management outcome

    International Nuclear Information System (INIS)

    Saaiq, M.; Shah, S. A.

    2008-01-01

    To determine the presentation and management outcome of thoracic trauma in a tertiary care setting. A total of 143 patients, who presented with chest trauma, were included in the study. All the patients were assessed by the history, physical examination and ancillary investigations. Appropriate managements were instituted as required. Data was described in percentages. out of 143 patients, 119 (83)% were males and 24 (17)% were females. Most of the patients belonged to the age group of 21-50 years. Ninety seven (66)% patients were admitted for indoor management. Blunt injury was found in 125 (87.4%) patients, while penetrating injuries in only 18 (12.6%) patients. Road Traffic Accidents (RTAs) were the commonest cause of trauma (n=103, 72%). Rib fracture was the commonest chest injury (74% patients). Head injury was the most frequently associated injury (18% of the patients). Tube thoracostomy was the commonest intervention undertaken in 65 (45%) patients. Seventeen (11.88%) patients were managed with mechanical ventilation. there were 17 deaths with a mortality rate of 11.88%. Thoracic trauma is an important cause of hospitalization, morbidity and mortality in the younger population. RTAs constitute the leading cause of thoracic trauma in our setup. Tube thoracostomy is the most frequent and at times the only invasive procedure required as a definitive measure in thoracic trauma patients. A policy of selective hospitalization helps to avoid unnecessary hospital admissions. (author)

  1. Thermal injury lowers the threshold for radiation-induced neuroinflammation and cognitive dysfunction.

    Science.gov (United States)

    Cherry, Jonathan D; Williams, Jacqueline P; O'Banion, M Kerry; Olschowka, John A

    2013-10-01

    The consequences of radiation exposure alone are relatively well understood, but in the wake of events such as the World War II nuclear detonations and accidents such as Chernobyl, other critical factors have emerged that can substantially affect patient outcome. For example, ~70% of radiation victims from Hiroshima and Nagasaki received some sort of additional traumatic injury, the most common being thermal burn. Animal data has shown that the addition of thermal insult to radiation results in increased morbidity and mortality. To explore possible synergism between thermal injury and radiation on brain, C57BL/6J female mice were exposed to either 0 or 5 Gy whole-body gamma irradiation. Irradiation was immediately followed by a 10% total-body surface area full thickness thermal burn. Mice were sacrificed 6 h, 1 week or 6 month post-injury and brains and plasma were harvested for histology, mRNA analysis and cytokine ELISA. Plasma analysis revealed that combined injury synergistically upregulates IL-6 at acute time points. Additionally, at 6 h, combined injury resulted in a greater upregulation of the vascular marker, ICAM-1 and TNF-α mRNA. Enhanced activation of glial cells was also observed by CD68 and Iba1 immunohistochemistry at all time points. Additionally, doublecortin staining at 6 months showed reduced neurogenesis in all injury conditions. Finally, using a novel object recognition test, we observed that only mice with combined injury had significant learning and memory deficits. These results demonstrate that thermal injury lowers the threshold for radiation-induced neuroinflammation and long-term cognitive dysfunction.

  2. 中医手法整复并超激光脊神经根照射治疗胸椎关节综合征%The treatment of traditional Chinese medicine combined with ultra laser radiation on patients with disturbance syndrome of thoracic vertebral joint

    Institute of Scientific and Technical Information of China (English)

    侯艾云; 王锦丽

    2003-01-01

    @@ INTRODUCTION The disturbance syndrome of thoracic vertebral joint means theclinical syndrome mainly indicating backache caused because ofsecondary injury of spinal nerve root and/or sympathetic nervecaused by joint disturbance of intervertebral discs of thoracic ver-tebrac, zygapophyseal joints and proper joint of thoracic verte-brae. Because the symptoms and signs are complicated, it often ismisdiagnosed as diseases in respiratory system, cardiovascular sys-tem or alimentary system and can not achieve thorough treatment,which used to be cured with drugs, acupuncture and physiotherapybut the effect is not satisfying.

  3. Radiation injury of the skin following diagnostic and interventional fluoroscopic procedures

    International Nuclear Information System (INIS)

    Koenig, T.R.; Wagner, L.K.; Mettler, F.A.

    2001-01-01

    Many radiation injuries to the skin, resulting from diagnostic and interventional fluoroscopic procedures, have been reported in recent years. In some cases skin damage was severe and debilitating. We analyzed 72 reports of skin injuries for progression and location of injury, type and number of procedures, and contributing patient and operator factors. Most cases (46) were related to coronary angiography and percutaneous transluminal coronary angioplasty (PTCA). A smaller number was documented after cardiac radiofrequency catheter ablation (12), transjugular intrahepatic portosystemic shunt (TIPS) placement (7), neuroradiological interventions (3) and other procedures (4). Important factors leading to skin injuries were long exposure times over the same skin area, use of high dose rates, irradiation through thick tissue masses, hypersensitivity to radiation, and positioning of arms or breasts into the radiation entrance beam. Physicians were frequently unaware of the high radiation doses involved and did not recognize the injuries as radiation induced. Based on these findings, recommendations to reduce dose and improve patient care are provided. (author)

  4. Avoidance of radiation injuries from medical interventional procedures, ICRP Publication 85

    International Nuclear Information System (INIS)

    Valentin, J.

    2000-01-01

    Interventional radiology (fluoroscopically-guided) techniques are being used by an increasing number of clinicians not adequately trained in radiation safety or radiobiology. Many of these interventionists are not aware of the potential for injury from these procedures or the simple methods for decreasing their incidence. Many patients are not being counselled on the radiation risks, nor followed up when radiation doses from difficult procedures may lead to injury. Some patients are suffering radiation-induced skin injuries and younger patients may face an increased risk of future cancer. Interventionists are having their practice limited or suffering injury, and are exposing their staff to high doses. In some interventional procedures, skin doses to patients approach those experienced in some cancer radiotherapy fractions. Radiation-induced skin injuries are occurring in patients due to the use of inappropriate equipment and, more often, poor operational technique. Injuries to physicians and staff performing interventional procedures have also been observed. Acute radiation doses (to patients) may cause erythema at 2 Gy, cataract at 2 Gy, permanent epilation at 7 Gy, and delayed skin necrosis at 12 Gy. Protracted (occupational) exposures to the eye may cause cataract at 4 Gy if the dose is received in less than 3 months, at 5.5 Gy if received over a period exceeding 3 months. Practical actions to control dose to the patient and to the staff are listed. The absorbed dose to the patient in the area of skin that receives the maximum dose is of priority concern. Each local clinical protocol should include, for each type of interventional procedure, a statement on the cumulative skin doses and skin sites associated with the various parts of the procedure. Interventionists should be trained to use information on skin dose and on practical techniques to control dose. Maximum cumulative absorbed doses that appear to approach or exceed 1 Gy (for procedures that may be

  5. Avoidance of radiation injuries from medical interventional procedures, ICRP Publication 85

    Energy Technology Data Exchange (ETDEWEB)

    Valentin, J

    2000-06-01

    Interventional radiology (fluoroscopically-guided) techniques are being used by an increasing number of clinicians not adequately trained in radiation safety or radiobiology. Many of these interventionists are not aware of the potential for injury from these procedures or the simple methods for decreasing their incidence. Many patients are not being counselled on the radiation risks, nor followed up when radiation doses from difficult procedures may lead to injury. Some patients are suffering radiation-induced skin injuries and younger patients may face an increased risk of future cancer. Interventionists are having their practice limited or suffering injury, and are exposing their staff to high doses. In some interventional procedures, skin doses to patients approach those experienced in some cancer radiotherapy fractions. Radiation-induced skin injuries are occurring in patients due to the use of inappropriate equipment and, more often, poor operational technique. Injuries to physicians and staff performing interventional procedures have also been observed. Acute radiation doses (to patients) may cause erythema at 2 Gy, cataract at 2 Gy, permanent epilation at 7 Gy, and delayed skin necrosis at 12 Gy. Protracted (occupational) exposures to the eye may cause cataract at 4 Gy if the dose is received in less than 3 months, at 5.5 Gy if received over a period exceeding 3 months. Practical actions to control dose to the patient and to the staff are listed. The absorbed dose to the patient in the area of skin that receives the maximum dose is of priority concern. Each local clinical protocol should include, for each type of interventional procedure, a statement on the cumulative skin doses and skin sites associated with the various parts of the procedure. Interventionists should be trained to use information on skin dose and on practical techniques to control dose. Maximum cumulative absorbed doses that appear to approach or exceed 1 Gy (for procedures that may be

  6. Successful Mitigation of Delayed Intestinal Radiation Injury Using Pravastatin is not Associated with Acute Injury Improvement or Tumor Protection

    International Nuclear Information System (INIS)

    Haydont, Valerie; Gilliot, Olivier; Rivera, Sofia; Bourgier, Celine; Francois, Agnes; Aigueperse, Jocelyne; Bourhis, Jean; Vozenin-Brotons, Marie-Catherine

    2007-01-01

    Purpose: To investigate whether pravastatin mitigates delayed radiation-induced enteropathy in rats, by focusing on the effects of pravastatin on acute cell death and fibrosis according to connective tissue growth factor (CTGF) expression and collagen inhibition. Methods and Materials: Mitigation of delayed radiation-induced enteropathy was investigated in rats using pravastatin administered in drinking water (30 mg/kg/day) 3 days before and 14 days after irradiation. The ileum was irradiated locally after surgical exteriorization (X-rays, 19 Gy). Acute apoptosis, acute and late histologic alterations, and late CTGF and collagen deposition were monitored by semiquantitative immunohistochemistry and colorimetric staining (6 h, 3 days, 14 days, 15 weeks, and 26 weeks after irradiation). Pravastatin antitumor action was studied in HT-29, HeLa, and PC-3 cells by clonogenic cell survival assays and tumor growth delay experiments. Results: Pravastatin improved delayed radiation enteropathy in rats, whereas its benefit in acute and subacute injury remained limited (6 h, 3 days, and 14 days after irradiation). Delayed structural improvement was associated with decreased CTGF and collagen deposition but seemed unrelated to acute damage. Indeed, the early apoptotic index increased, and severe subacute structural damage occurred. Pravastatin elicited a differential effect, protecting normal intestine but not tumors from radiation injury. Conclusion: Pravastatin provides effective protection against delayed radiation enteropathy without interfering with the primary antitumor action of radiotherapy, suggesting that clinical transfer is feasible

  7. Detection of radiation induced lung injury in rats using dynamic hyperpolarized {sup 129}Xe magnetic resonance spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Matthew S. [Department of Physics and Astronomy, Western University, London, Ontario, N6A 3K7, Canada and Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, N6A 5B7 (Canada); Ouriadov, Alexei; Hegarty, Elaine [Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, N6A 5B7 (Canada); Thind, Kundan [Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada and Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, N6A 5B7 (Canada); Wong, Eugene [Department of Physics and Astronomy, Western University, London, Ontario, N6A 3K7, Canada and London Regional Cancer Program, London, Ontario, N6C 2R6 (Canada); Hope, Andrew [Department of Radiation Oncology, University of Toronto, Toronto, Ontario, M5S 3E2, Canada and Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario, M5T 2M9 (Canada); Santyr, Giles E., E-mail: gsantyr@robarts.ca [Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1 (Canada); Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, N6A 5B7 (Canada); Department of Medical Imaging, Western University, London, Ontario, N6A 5B7 (Canada)

    2014-07-15

    Purpose: Radiation induced lung injury (RILI) is a common side effect for patients undergoing thoracic radiation therapy (RT). RILI can lead to temporary or permanent loss of lung function and in extreme cases, death. Combining functional lung imaging information with conventional radiation treatment plans may lead to more desirable treatment plans that reduce lung toxicity and improve the quality of life for lung cancer survivors. Magnetic Resonance Imaging of the lung following inhalation of hyperpolarized{sup 129}Xe may provide a useful nonionizing approach for probing changes in lung function and structure associated with RILI before, during, or after RT (early and late time-points). Methods: In this study, dynamic{sup 129}Xe MR spectroscopy was used to measure whole-lung gas transfer time constants for lung tissue and red blood cells (RBC), respectively (T{sub Tr-tissue} and T{sub Tr-RBC}) in groups of rats at two weeks and six weeks following 14 Gy whole-lung exposure to radiation from a {sup 60}Co source. A separate group of six healthy age-matched rats served as a control group. Results: T{sub Tr-tissue} values at two weeks post-irradiation (51.6 ± 6.8 ms) were found to be significantly elevated (p < 0.05) with respect to the healthy control group (37.2 ± 4.8 ms). T{sub Tr-RBC} did not show any significant changes between groups. T{sub Tr-tissue} was strongly correlated with T{sub Tr-RBC} in the control group (r = 0.9601 p < 0.05) and uncorrelated in the irradiated groups. Measurements of arterial partial pressure of oxygen obtained by arterial blood sampling were found to be significantly decreased (p < 0.05) in the two-week group (54.2 ± 12.3 mm Hg) compared to those from a representative control group (85.0 ± 10.0 mm Hg). Histology of a separate group of similarly irradiated animals confirmed the presence of inflammation due to radiation exposure with alveolar wall thicknesses that were significantly different (p < 0.05). At six weeks post

  8. The need for and the importance of biological indicators of radiation effects with special reference to injuries in radiation accidents

    International Nuclear Information System (INIS)

    Koeteles, G.J.; Bianco, A.

    1982-01-01

    The need for further research on the existing and new biological indicators of radiation injury has been expressed. The studies on the radiation-induced alterations of membrane structure and function stimulated investigations aiming to develop an indicator based on membrane-phenomena. The co-ordinated research programme on ''Cell Membrane Probes as Biological Indicators of Radiation Injury in Radiation Accidents'' was initiated in mid 1977 and terminated in 1980. Within this programme many basic observations were made in connection with altered features of various animal and human cell membranes. Molecular, biophysical, biochemical and cell biological approaches were performed. The rapid reaction within minutes or hours of membranes against relatively low doses of various types of irradiations were described and the effects proved to be transitory, i.e. membrane regeneration occurred within hours. These dose- and timedependent alterations suggest the possibility of developing a biological indicator which would give signals at the earliest period after radiation injury when no other biological informations are available. The importance of a system of biological indicators is emphasized. (author)

  9. Reduction of radiation injury of fresh agricultural products by saccharide

    International Nuclear Information System (INIS)

    Todoroki, Setsuko; Hayashi, Toru

    1999-01-01

    Radiation exposure has been paid attention as an alternative technique of methylbromide to protect agricultural products against insects. However, it has been pointed out that radiation at a dose lower than 300-400 Gy necessary for insecticidal effects might produce damages in fresh agricultural products. To reduce such radiation damages, radiation sensitivities of various fresh products were determined to clarify whether sugar treatment is effective for reduction of damages. Further, the timing of the treatment and its influence on the metabolism of agricultural product were investigated. When sucrose was added to a cut flower of chrysanthemum via water before and during irradiation, the withering time of its leaves and flowers was earlier than that of the untreated product, whereas continuous administration of sucrose after radiation exposure caused to lengthen the flower's life and delay the leave's yellowing. Thus, it was indicated that continuous sugar supply after irradiation was effective for prevention of radiation damages. (M.N.)

  10. A meta-analysis of lymph node metastasis rate for patients with thoracic oesophageal cancer and its implication in delineation of clinical target volume for radiation therapy

    Science.gov (United States)

    Ding, X; Zhang, J; Li, B; Wang, Z; Huang, W; Zhou, T; Wei, Y; Li, H

    2012-01-01

    Objectives The objective of this study was to pool the lymph node metastasis rate (LNMR) in patients with thoracic oesophageal cancer (TOC) and to determine which node level should be included when undergoing radiation therapy. Methods Qualified studies were identified on Medline, Embase, CBM and the Cochrane Library through to the end of April 2011. Pooled estimates of LNMR were obtained through a random-effect model. Possible effect modifiers which might lead to the statistical heterogeneity were identified through meta-regression, and further subgroup analyses of factors influencing LNMR were performed. Results 45 observational studies with a total of 18 415 patients were included in the meta-analysis. The pooled estimates of LNMR in upper, middle and lower TOC were 30.7%, 16.8% and 11.0% cervical, 42.0%, 21.1% and 10.5% upper mediastinal, 12.9%, 28.1% and 19.6% middle mediastinal, 2.6%, 7.8% and 23.0% lower mediastinal, and 9%, 21.4% and 39.9% abdominal, respectively. Lymph node metastasis most frequently happened to paratracheal, paraoesophageal, perigastric 106recR and station 7. The most obvious difference (≥15%) of LNMR between two-field and three-field lymphatic dissection occurred in cervical, paratracheal, 106recR and 108. Conclusions Through the meta-analysis, more useful information was obtained about clinical target volume (CTV) delineation of TOC patients treated with radiotherapy. However, our study is predominantly a description of squamous carcinoma and the results may not be valid for adenocarcinoma. PMID:22700258

  11. Phantom examination for reduction of radiation dose using new needle screen storage phosphor radiography and add beam filter in digital thoracic radiography on adolescents and larger children

    International Nuclear Information System (INIS)

    Heyne, J.P.; Mentzel, H.J.; Neumann, R.; Lopatta, E.; Zimmermann, U.; Kaiser, W.A.

    2008-01-01

    Purpose: how much can the radiation dose be reduced in thoracic radiography on adolescents and larger children by using needle screen storage phosphor (NIP) radiography and add beam filtration? Materials and methods: a chest phantom with typical anatomical structures, pathological findings, added catheters, and simulated nodules, tumors, and calcifications was X-rayed digitally (DX-S, Agfa Healthcare) in posterior-anterior (p.a.) orientation with and without add beam filter. While keeping the voltage constant, the tube current time product was reduced gradually. In addition to LgM, the surface entrance dose (ED) and the dose area product (DAP) were measured by the Dosimax sensor and Kerma X-plus (both Wellhoefer). Five investigators evaluated the images for characteristics and critical features, pathological findings, and catheter recognizability. Results: the ED of the digital chest radiogram p.a. with 115 kV and 0.71 mAs was 27 μGy, the DAP 3.6 μGy x m 2 , the LgM value 1.56. This initial radiogram was able to be evaluated very well and conforms to the quality guidelines. The dose-reduced chest radiograms with the add beam filter Al 1.0 mm/Cu 0.1 mm were evaluated as sufficiently reduced to a dose of 63% of the initial dose, with the add beam filter Al 1.0 mm/Cu 0.2 mm reduced to 50% (0.52 mAs, DAP 1.82 μGy x m 2 , LgM 1.35). P.a. radiograms were able to be X-rayed on 115 kV with 0.52 mAs. (orig.)

  12. Organization of medical aid and treatment of victims of mass ionizing radiation injuries

    International Nuclear Information System (INIS)

    Gus'kova, A.K.; Burenin, P.I.; Barabanova, A.V.

    1987-01-01

    General organization points on medical aid and treatment of mass ionizing radiation injuries in population are presented. Characteristic of losses and structure of injuries induced by a nuclear explosion are given. Destructions in a town caused by a nuclear explosion and medical aid conditions for patients are analysed. Main information about structure of medical surveillance of civil defence and criteria of medical classification and evacuation of the injured are presented

  13. Clinical evaluation of dose-volume-effect relationship in radiation injury of the brain

    International Nuclear Information System (INIS)

    Saito, Mari

    1990-01-01

    Radiation brain injury, including functional disturbances or morphological changes (brain atrophy, periventricular lucencies or ventricular dilatation), were studied by CT in patients with primary intracranial neoplasms who were followed-up for at least 5 months after receiving radiotherapy. Each of 33 patients with medulloblastoma, pinealregion tumor or malignant lymphoma received a total dose of 40-61 Gy by conventional fractionation using a whole brain irradiation field boosted by a localized field. Of these patients, 19 (58%) developed radiation brain injury. It was concluded that the volume-dose was one of the most important factors influencing the development of radiation brain injury. Age at the time of radiotherapy and time of follow-up after the treatment were also considered to be important factors. (author)

  14. Thoracic posture, shoulder muscle activation patterns and isokinetic ...

    African Journals Online (AJOL)

    Background. Shoulder injuries are the most severe injuries in rugby union players, accounting for almost 20% of injuries related to the sport and resulting in lost playing hours. Objective. To profile the thoracic posture, scapular muscle activation patterns and rotator cuff muscle isokinetic strength of semi-professional

  15. Effects of different components of serum after radiation, burn and combined radiation-burn injury on inward rectifier potassium channel of myocardial cells

    International Nuclear Information System (INIS)

    Ye Benlan; Cheng Tianmin; Xiao Jiasi

    1997-01-01

    Objective: To study the effects of different components of serum in rats inflicted with radiation, burn and combined radiation-burn injury on inward rectifier potassium channel of cultured myocardial cells. Method: Using patch clamp method to study the action of single ion channel. Results: The low molecular and lipid components of serum after different injuries models could all activate the inward rectifier potassium channel in cultured myocardial cells. The components of serum after combined radiation-burn injury showed the most significant effect, and the way of this effect was different from that from single injury. Conclusion: The serum components post injury altered the electric characteristic of myocardial cells, which may play a role in the combined effect of depressed cardiac function after combined radiation-burn injury

  16. Awareness of radiation exposure of thoracic CT scans and conventional radiographs: what do non-radiologists know?

    International Nuclear Information System (INIS)

    Heyer, C.M.; Peters, S.; Lemburg, S.; Nicolas, V.

    2007-01-01

    Purpose: Assessment of the knowledge of non-radiological physicians concerning radiation exposure during radiological procedures on the thorax. Material and Methods: 124 non-radiological physicians from the departments of surgery, internal medicine, anesthesiology, and neurology at a university hospital were questioned during a four-week period using a standardized questionnaire as to the effective dose (ED) of different radiological procedures on the thorax. The interviewees were asked to estimate the ED of chest X-rays and CT examinations and to compare these with the ED of other radiological methods. Length of professional experience, field of clinical training, and hierarchical position were also documented. The T-test and chi-square test were used for statistical analysis. Results: 119/124 (96.0 %) physicians with an average work experience of 8.2 years (0.3 - 32 years) were willing to participate. 47/119 (39.5 %) correctly estimated the ED of conventional chest X-ray (0.01 - 0.1 mSv), and 40/119 (33.6 %) correctly gauged the ED of adult chest CT (1 - 10 mSv). The ED of cardiac CT and pediatric chest CT without dose reduction (10 - 100 mSv) were correctly judged by 31/119 (26.1 %) and 32/119 (26.9 %), respectively. The correct ratio of the ED of chest X-ray to that of chest CT (factor 100 - 1000) was given by 28/119 (23.5 %), while 86/119 (72.3 %) underestimated the ratio. 50/119 (42.0 %) and 35/119 (29.4 %) correctly stated that the ED of pediatric chest CT without dose reduction and that of cardiac CT are greater than that of adult chest CT. 24/119 (20.2 %) and 10/119 (8.4 %) thought that the ED of low-dose chest CT is smaller than that of chest X-ray or chest MRI, respectively. The length of professional experience, field of clinical training, and hierarchical position of the participants did not have a significant influence on the test results. (orig.)

  17. Study of cell cycle and apoptosis after radiation with electron linear accelerator injury

    International Nuclear Information System (INIS)

    Xu Lan; Zhou Yinghui; Shi Ning; Peng Miao; Wu Shiliang

    2002-01-01

    Purpose: To determine the cell cycle and apoptosis of the injured cells after radiation with the electron linear accelerator. Methods: NIH 3T3 cells were irradiated by the radiation with the electron linear accelerator. In the experiment the condition of the cell cycle and apoptosis of the injured cells were measured. The expression of p53 was also tested. Results: After exposure to radiation, the number of apoptotic cells as well as the expression of p53 increased. Conclusion: The electron linear accelerator radiation injury can induce cell apoptosis

  18. Internal Thoracic Artery Encircled by an Unusual Phrenic Nerve Loop

    Directory of Open Access Journals (Sweden)

    Robert Fu-Chean Chen

    2007-12-01

    Full Text Available We report an anatomic variation of the phrenic nerve. During a routine gross anatomical dissection course at our medical university, we found an unusual loop of the left phrenic nerve around the internal thoracic artery, about 1 cm from the take-off of the left subclavian artery. The phrenic nerve is close to the internal thoracic artery and is easily injured when dissecting the internal thoracic artery for coronary artery bypass conduit. Therefore, we suggest that the anatomic relationship of the phrenic nerve and internal thoracic artery is important in preventing incidental injury of the phrenic nerve.

  19. First Patagonian Course on 'Diagnosis and Therapy of Injuries Induced by Ionizing Radiation'

    International Nuclear Information System (INIS)

    Bellotti, Mariela I.

    2013-01-01

    In Patagonia there are academic centers, health and industrial facilities that use ionizing radiations in its usual practices. However, they do not have protocols that respond to local needs. For this reason was held from October 5 to November 10, 2012 in Bariloche Atomic Center, a training course for health personnel. The range of topics covered ranged from the definition of dosimetry quantities, types of radiation and biological dosimetry, biological effects, radiation acute syndrome, radiation-induced cutaneous syndrome, internal contamination, screening in radiological emergencies, etc.The course provided a theoretical and practical guide about how to recognize and treat people exposed to radiations, guidelines for acting in radiological emergencies and a perception of the psychosocial impact of the radiation accidents.The result was a pocket book for health personnel that will be used in case of having a patient with radiation induced injury

  20. Effect of radiation sickness on the progress and treatment of mechanical and thermal injuries. [In German

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, K

    1964-04-01

    It has been estimated that 70 or 75% of persons exposed to atomic weapons would suffer mechanical and thermal injuries, and that 30% receive radiation injuries. Of the total persons injured, 75% would suffer combinations of these injuries. As a result the various injurious agents, complexes of injury conditions, would be observed. These include leukopenia and impaired resistance to infection, shortened delay in appearance o irradiation symptoms, intensified evidence of shock, and an increased tendency toward hemorrhage, with increased sensitivity to blood loss. The author discusses a wide range of general and specific medical procedures and drugs that can be used to treat and support recovery of persons with combined radiation and mechanical or thermal injuries. Some general treatment procedures include absolute isolation and rest, special dietetic supplementation, strict medical supervision to prevent acute hemorrhage or circulatory failure, and parenteral administration of fluids. Other special measures include treatment of the primary reactions to injury by antihistamines, sedatives, antibiotics, hormones, support of circulation, blood transfusions, etc.

  1. Effect of blood transfusion and skin grafting on rats with combined radiation-burn injury

    International Nuclear Information System (INIS)

    Yan Yongtang; Ran Xinze; Wei Shuqing

    1990-01-01

    The therapeutic effect of escharectomy and skin grafting at different times on rats with combined radiation-burn injuries (5 Gy total body irradiation plus flash radiation from a 5 kW bromotungstenic lamp to induce a 15% TBSA full thickness burn on back) treated with blood transfusion (BT) were studied. The treatment with BT and escharectomy plus skin grafting at 24, 48, and 72 h after injury showed significant therapeutic effects. In these treated groups, early recovery of WBC counts, the granulocytes and total lymphocytes, T, B-cells, bone marrow cells or CFU-F counts were evident within 30 days after injury. The 30-day survival rates of the skin grafts in the group treated with BT and skin grafting at 24 h after injury was 80%, in the group with skin grafting alone was 50%, while all the skin grafts sloughted within 30 days when the grafting was performed 48 and 72 h after injury. The 30-day survival rate of the recipients treated with skin grafting plus BT was higher than that of the animals with skin grafting alone. The results showed that satisfactory results were achieved with BT plus escharectomy and skin grafting within 24 h after injury, while skin grafting performed at 48 or 72 h after injury was ineffective for the survival of skin grafts

  2. Transection of the inferior vena cava from blunt thoracic trauma: case reports.

    Science.gov (United States)

    Peitzman, A B; Udekwu, A O; Pevec, W; Albrink, M

    1989-04-01

    Blunt thoracic trauma is a frequent cause of death in multiple trauma victims. Myocardial rupture may occur in up to 65% of patients who die with thoracic injuries. Two cases are presented with intrapericardial transection of the inferior vena cava, pericardial rupture, and myocardial rupture from blunt thoracic trauma. Both patients died.

  3. Effect of ozone oxidative preconditioning in preventing early radiation-induced lung injury in rats

    Energy Technology Data Exchange (ETDEWEB)

    Bakkal, B.H. [Department of Radiation Oncology, School of Medicine, Bulent Ecevit University, Kozlu, Zonguldak (Turkey); Gultekin, F.A. [Department of General Surgery, School of Medicine, Bulent Ecevit University, Kozlu, Zonguldak (Turkey); Guven, B. [Department of Biochemistry, School of Medicine, Bulent Ecevit University, Kozlu, Zonguldak (Turkey); Turkcu, U.O. [Mugla School of Health Sciences, Mugla Sitki Kocman University, Mugla (Turkey); Bektas, S. [Department of Pathology, School of Medicine, Bulent Ecevit University, Kozlu, Zonguldak (Turkey); Can, M. [Department of Biochemistry, School of Medicine, Bulent Ecevit University, Kozlu, Zonguldak (Turkey)

    2013-09-27

    Ionizing radiation causes its biological effects mainly through oxidative damage induced by reactive oxygen species. Previous studies showed that ozone oxidative preconditioning attenuated pathophysiological events mediated by reactive oxygen species. As inhalation of ozone induces lung injury, the aim of this study was to examine whether ozone oxidative preconditioning potentiates or attenuates the effects of irradiation on the lung. Rats were subjected to total body irradiation, with or without treatment with ozone oxidative preconditioning (0.72 mg/kg). Serum proinflammatory cytokine levels, oxidative damage markers, and histopathological analysis were compared at 6 and 72 h after total body irradiation. Irradiation significantly increased lung malondialdehyde levels as an end-product of lipoperoxidation. Irradiation also significantly decreased lung superoxide dismutase activity, which is an indicator of the generation of oxidative stress and an early protective response to oxidative damage. Ozone oxidative preconditioning plus irradiation significantly decreased malondialdehyde levels and increased the activity of superoxide dismutase, which might indicate protection of the lung from radiation-induced lung injury. Serum tumor necrosis factor alpha and interleukin-1 beta levels, which increased significantly following total body irradiation, were decreased with ozone oxidative preconditioning. Moreover, ozone oxidative preconditioning was able to ameliorate radiation-induced lung injury assessed by histopathological evaluation. In conclusion, ozone oxidative preconditioning, repeated low-dose intraperitoneal administration of ozone, did not exacerbate radiation-induced lung injury, and, on the contrary, it provided protection against radiation-induced lung damage.

  4. Protective effect of Hongxue tea mixture against radiation injury in mice

    International Nuclear Information System (INIS)

    Zhao Chun; Zhang Xuehui; Wang Qi

    2005-01-01

    Objective: To develop health food of anti-radiation among biological source in Yunnan. Methods: Screening test was done of the health food of biological source of anti-radiation injury in mice. It is indicated that Hong-Xue Tea Mixture among the biological source has the effect against radiation injury, observing experiment of dose-effect of Hong-Xue Tea Mixture was done. Micronuclei in the bone marrow polychromatophilic erythrocytes in each dose group of mice were examined, leucocytes number and 30 day survival rate of mice following whole-body 5.0 Gy γ irradiation were also determined. Results: Research showed that Hong-Xue Tea Mixture and Spirulina Platensis Mixture among the biological source have protective effect against radiation injury in mice. Observing experiment of dose-effect of Hong-Xue Tea Mixture show that low, medium and high dose of Hong-Xue Tea Mixture can significantly decrease bone marrow PECMN rate of mice, increase leucocytes number and 30 day survival rate. Conclusion: Hong-Xue Tea Mixture has potent protective effects against radiation injury in mice. (authors)

  5. Effect of ozone oxidative preconditioning in preventing early radiation-induced lung injury in rats

    International Nuclear Information System (INIS)

    Bakkal, B.H.; Gultekin, F.A.; Guven, B.; Turkcu, U.O.; Bektas, S.; Can, M.

    2013-01-01

    Ionizing radiation causes its biological effects mainly through oxidative damage induced by reactive oxygen species. Previous studies showed that ozone oxidative preconditioning attenuated pathophysiological events mediated by reactive oxygen species. As inhalation of ozone induces lung injury, the aim of this study was to examine whether ozone oxidative preconditioning potentiates or attenuates the effects of irradiation on the lung. Rats were subjected to total body irradiation, with or without treatment with ozone oxidative preconditioning (0.72 mg/kg). Serum proinflammatory cytokine levels, oxidative damage markers, and histopathological analysis were compared at 6 and 72 h after total body irradiation. Irradiation significantly increased lung malondialdehyde levels as an end-product of lipoperoxidation. Irradiation also significantly decreased lung superoxide dismutase activity, which is an indicator of the generation of oxidative stress and an early protective response to oxidative damage. Ozone oxidative preconditioning plus irradiation significantly decreased malondialdehyde levels and increased the activity of superoxide dismutase, which might indicate protection of the lung from radiation-induced lung injury. Serum tumor necrosis factor alpha and interleukin-1 beta levels, which increased significantly following total body irradiation, were decreased with ozone oxidative preconditioning. Moreover, ozone oxidative preconditioning was able to ameliorate radiation-induced lung injury assessed by histopathological evaluation. In conclusion, ozone oxidative preconditioning, repeated low-dose intraperitoneal administration of ozone, did not exacerbate radiation-induced lung injury, and, on the contrary, it provided protection against radiation-induced lung damage

  6. Impact of an angiotensin analogue in treating thermal and combined radiation injuries

    Science.gov (United States)

    Jadhav, Sachin Suresh

    Background: In recent years there has been a growing concern regarding the use of nuclear weapons by terrorists. Such incidents in the past have shown that radiation exposure is often accompanied by other forms of trauma such as burns, wounds or infection; leading to increased mortality rates among the affected individuals. This increased risk with combined radiation injury has been attributed to the delayed wound healing observed in this injury. The Renin-Angiotensin System (RAS) has emerged as a critical regulator of wound healing. Angiotensin II (A-II) and Angiotensin (1-7) [A(1-7)] have been shown to accelerate the rate of wound healing in different animal models of cutaneous injury. Nor-Leu3-Angiotensin (1-7) [Nor-Leu3-A (1-7)], an analogue of A(1-7), is more efficient than both A-II and A(1-7) in its ability to improve wound healing and is currently in phase III clinical trials for the treatment of diabetic foot ulcers. Aims: The three main goals of this study were to; 1) Develop a combined radiation and burn injury (CRBI) model and a radiation-induced cutaneous injury model to study the pathophysiological effects of these injuries on dermal wound healing; 2) To treat thermal and CRBI injuries using Nor-Leu 3-A (1-7) and decipher the mechanism of action of this peptide and 3) Develop an in-vitro model of CRBI using dermal cells in order to study the effect of CRBI on individual cell types involved in wound healing. Results: CRBI results in delayed and exacerbated apoptosis, necrosis and inflammation in injured skin as compared to thermal injury by itself. Radiation-induced cutaneous injury shows a radiation-dose dependent increase in inflammation as well as a chronic inflammatory response in the higher radiation exposure groups. Nor-Leu3-A (1-7) can mitigate thermal and CRBI injuries by reducing inflammation, oxidative stress and DNA damage while increasing the rate of proliferation of dermal stem cells and re-epithelialization of injured skin. The in

  7. Detection of radiation brain injury of malignant glioma by 1H-MRS

    International Nuclear Information System (INIS)

    Zhang Mao; Jin Haiguo; Sun Shuquan; Bu Mingwei; Su Qingxiu; Liu Guigang; Sun Baosheng

    2011-01-01

    Objective: Using proton magnetic resonance spectroscopy ( 1 H-MRS) method, to evaluate the difference of radiation brain injury between volumetric modulated arc therapy (VMAT) and three-dimensional conformal radiation therapy (3DCRT) in patients with postoperative glioma after radiation therapy. Methods: 24 patients with malignant glioma (WHOII-IV grade glioma) confirmed with clinical surgery were selected, among them 12 patients were treated with VMAT technique, and another 12 patients with 3DCRT technique, all received DT60-66GY/30-33F dose prescriptions. 1 H-MRS examination was performed to analyze the change of metabolites in the brain tissues of region of interest (ROI) before and after radiotherapy,and the ratios of NAA/ Cr, Cho / Cr, NAA / Cho were computed. Results: The dose distribution of VMAT group was superior to 3DCRT group, the NAA/Cr in two groups after radiation were decreased compared with before radiation, there was a statistically difference in NAA/Cr after radiation between two groups (P<0.01). The Cho / Cr and NAA / Cho in two groups were increased compared with before radiation;after radiation, only NAA/Cho had a statistical difference between two groups (P<0.01). Conclusion: VMAT technique is superior to 3DCTR to reduce radiation brain injury in patients with postoperative glioma. (authors)

  8. A Nonhuman Primate Model of Human Radiation-Induced Venocclusive Liver Disease and Hepatocyte Injury

    Energy Technology Data Exchange (ETDEWEB)

    Yannam, Govardhana Rao [Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska (United States); Han, Bing [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi' an Jiaotong University, Xi' an, Shaanxi (China); Setoyama, Kentaro [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Yamamoto, Toshiyuki [Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska (United States); Ito, Ryotaro; Brooks, Jenna M. [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Guzman-Lepe, Jorge [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Department of Pathology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); Galambos, Csaba [Department of Pathology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); Fong, Jason V. [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Deutsch, Melvin; Quader, Mubina A. [Department of Radiation Oncology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); Yamanouchi, Kosho [Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York (United States); Marion Bessin Liver Research Center, Albert Einstein College of Medicine, Bronx, New York (United States); Kabarriti, Rafi; Mehta, Keyur [Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York (United States); Soto-Gutierrez, Alejandro [Department of Pathology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); and others

    2014-02-01

    Background: Human liver has an unusual sensitivity to radiation that limits its use in cancer therapy or in preconditioning for hepatocyte transplantation. Because the characteristic veno-occlusive lesions of radiation-induced liver disease do not occur in rodents, there has been no experimental model to investigate the limits of safe radiation therapy or explore the pathogenesis of hepatic veno-occlusive disease. Methods and Materials: We performed a dose-escalation study in a primate, the cynomolgus monkey, using hypofractionated stereotactic body radiotherapy in 13 animals. Results: At doses ≥40 Gy, animals developed a systemic syndrome resembling human radiation-induced liver disease, consisting of decreased albumin, elevated alkaline phosphatase, loss of appetite, ascites, and normal bilirubin. Higher radiation doses were lethal, causing severe disease that required euthanasia approximately 10 weeks after radiation. Even at lower doses in which radiation-induced liver disease was mild or nonexistent, latent and significant injury to hepatocytes was demonstrated by asialoglycoprotein-mediated functional imaging. These monkeys developed hepatic failure with encephalopathy when they received parenteral nutrition containing high concentrations of glucose. Histologically, livers showed central obstruction via an unusual intimal swelling that progressed to central fibrosis. Conclusions: The cynomolgus monkey, as the first animal model of human veno-occlusive radiation-induced liver disease, provides a resource for characterizing the early changes and pathogenesis of venocclusion, for establishing nonlethal therapeutic dosages, and for examining experimental therapies to minimize radiation injury.

  9. A Nonhuman Primate Model of Human Radiation-Induced Venocclusive Liver Disease and Hepatocyte Injury

    International Nuclear Information System (INIS)

    Yannam, Govardhana Rao; Han, Bing; Setoyama, Kentaro; Yamamoto, Toshiyuki; Ito, Ryotaro; Brooks, Jenna M.; Guzman-Lepe, Jorge; Galambos, Csaba; Fong, Jason V.; Deutsch, Melvin; Quader, Mubina A.; Yamanouchi, Kosho; Kabarriti, Rafi; Mehta, Keyur; Soto-Gutierrez, Alejandro

    2014-01-01

    Background: Human liver has an unusual sensitivity to radiation that limits its use in cancer therapy or in preconditioning for hepatocyte transplantation. Because the characteristic veno-occlusive lesions of radiation-induced liver disease do not occur in rodents, there has been no experimental model to investigate the limits of safe radiation therapy or explore the pathogenesis of hepatic veno-occlusive disease. Methods and Materials: We performed a dose-escalation study in a primate, the cynomolgus monkey, using hypofractionated stereotactic body radiotherapy in 13 animals. Results: At doses ≥40 Gy, animals developed a systemic syndrome resembling human radiation-induced liver disease, consisting of decreased albumin, elevated alkaline phosphatase, loss of appetite, ascites, and normal bilirubin. Higher radiation doses were lethal, causing severe disease that required euthanasia approximately 10 weeks after radiation. Even at lower doses in which radiation-induced liver disease was mild or nonexistent, latent and significant injury to hepatocytes was demonstrated by asialoglycoprotein-mediated functional imaging. These monkeys developed hepatic failure with encephalopathy when they received parenteral nutrition containing high concentrations of glucose. Histologically, livers showed central obstruction via an unusual intimal swelling that progressed to central fibrosis. Conclusions: The cynomolgus monkey, as the first animal model of human veno-occlusive radiation-induced liver disease, provides a resource for characterizing the early changes and pathogenesis of venocclusion, for establishing nonlethal therapeutic dosages, and for examining experimental therapies to minimize radiation injury

  10. PAI-1-dependent endothelial cell death determines severity of radiation-induced intestinal injury.

    Directory of Open Access Journals (Sweden)

    Rym Abderrahmani

    Full Text Available Normal tissue toxicity still remains a dose-limiting factor in clinical radiation therapy. Recently, plasminogen activator inhibitor type 1 (SERPINE1/PAI-1 was reported as an essential mediator of late radiation-induced intestinal injury. However, it is not clear whether PAI-1 plays a role in acute radiation-induced intestinal damage and we hypothesized that PAI-1 may play a role in the endothelium radiosensitivity. In vivo, in a model of radiation enteropathy in PAI-1 -/- mice, apoptosis of radiosensitive compartments, epithelial and microvascular endothelium was quantified. In vitro, the role of PAI-1 in the radiation-induced endothelial cells (ECs death was investigated. The level of apoptotic ECs is lower in PAI-1 -/- compared with Wt mice after irradiation. This is associated with a conserved microvascular density and consequently with a better mucosal integrity in PAI-1 -/- mice. In vitro, irradiation rapidly stimulates PAI-1 expression in ECs and radiation sensitivity is increased in ECs that stably overexpress PAI-1, whereas PAI-1 knockdown increases EC survival after irradiation. Moreover, ECs prepared from PAI-1 -/- mice are more resistant to radiation-induced cell death than Wt ECs and this is associated with activation of the Akt pathway. This study demonstrates that PAI-1 plays a key role in radiation-induced EC death in the intestine and suggests that this contributes strongly to the progression of radiation-induced intestinal injury.

  11. The use of computer in the biological dosimetry of radiation injury with lymphocyte micronucleus

    International Nuclear Information System (INIS)

    Jiang Benrong; Yao Buo

    1994-01-01

    A new approach for determining by computer the radiation dosage in early diagnosis of radiation injury was presented, with a purpose to widen its practical application. A set of programs designed in Clanguage for computing and drawing was compiled. The technical details discussed here can be used for compiling other kinds of practical programs. It is a valuable attempt in improving the efficiency of the computer-aid clinical diagnosis

  12. Sphincter-saving procedure for radiation-injuried rectum

    International Nuclear Information System (INIS)

    Moriya, Yoshihiro; Koyama, Yasuo; Hojo, Keiichi

    1982-01-01

    Up to this time the sigmoid colostomy has been widely accepted and conventional treatment for radiation-injured rectum, but patients without residual malignancy strongly desire to live without colostomy. We have tried to remove the involved rectal segments by sphincter-saving procedures. Four patients underwent these procedures, pull-through procedure in three and low anterior resection in one. Among sphincter-saving procedures, pull-through procedure was most adequate. Provided the following five conditions are fulfilled, pull-through procedure should be considered for severe radiation-injured rectum. (1) No recurrence of initial malignancy in the pelvis. (2) More than 2 cm intact rectal segment above dentate line may be preserved. (3) No radiation-injured segment in upper sigmoid. (4) No severe radiation damage in small intestine. (5) Patients under 70 year-old, with normal tonus of anal sphincter. (author)

  13. Thoracic CT findings at hypovolemic shock

    International Nuclear Information System (INIS)

    Rotondo, A.; Angelelli, G.; Catalano, O.; Grassi, R.; Scialpi, M.

    1998-01-01

    Purpose: To describe and discuss the thoracic CT features of hypovolemic shock. Material and Methods: From a group of 18 patients with signs of hypovolemia on contrast-enhanced abdominal CT, 11 were selected for our study as having also undergone a complete chest examination. Pulse rate, blood pressure, trauma score value, Glasgow coma scale value, surgical result, and final outcome were retrospectively evaluated. The CT features analyzed were: decreased cardiac volume, reduced caliber of the thoracic aorta, aortic branches and caval venous system, increased enhancement of the aorta, and increased enhancement of the pulmonary collapses/contusions. Results: All 11 subjects presented severe injuries and hemodynamic instability; 7 were stable enough to undergo surgery; only 1 of the 11 survived. Two patients showed none of the features of thoracic hypovolemia. All the other patients presented at least two signs: reduced caliber of the thoracic aorta in 7 cases; decreased volume of the cardiac chambers and increased aortic enhancement in 6; decreased caliber of the aortic vessels in 4; decreased caliber of the caval veins in 3; and increased enhancement of the pulmonary collapses/contusions in 3. Conclusions: In patients with hypovolemia, CT may show several thoracic findings in addition to abdominal ones. Knowledge of these features is important for distinguishing them from traumatic injuries. (orig.)

  14. Intestinal Microbiota-Derived Metabolomic Blood Plasma Markers for Prior Radiation Injury

    International Nuclear Information System (INIS)

    Ó Broin, Pilib; Vaitheesvaran, Bhavapriya; Saha, Subhrajit; Hartil, Kirsten; Chen, Emily I.; Goldman, Devorah; Fleming, William Harv; Kurland, Irwin J.; Guha, Chandan; Golden, Aaron

    2015-01-01

    Purpose: Assessing whole-body radiation injury and absorbed dose is essential for remediation efforts following accidental or deliberate exposure in medical, industrial, military, or terrorist incidents. We hypothesize that variations in specific metabolite concentrations extracted from blood plasma would correlate with whole-body radiation injury and dose. Methods and Materials: Groups of C57BL/6 mice (n=12 per group) were exposed to 0, 2, 4, 8, and 10.4 Gy of whole-body gamma radiation. At 24 hours after treatment, all animals were euthanized, and both plasma and liver biopsy samples were obtained, the latter being used to identify a distinct hepatic radiation injury response within plasma. A semiquantitative, untargeted metabolite/lipid profile was developed using gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry, which identified 354 biochemical compounds. A second set of C57BL/6 mice (n=6 per group) were used to assess a subset of identified plasma markers beyond 24 hours. Results: We identified a cohort of 37 biochemical compounds in plasma that yielded the optimal separation of the irradiated sample groups, with the most correlated metabolites associated with pyrimidine (positively correlated) and tryptophan (negatively correlated) metabolism. The latter were predominantly associated with indole compounds, and there was evidence that these were also correlated between liver and plasma. No evidence of saturation as a function of dose was observed, as has been noted for studies involving metabolite analysis of urine. Conclusions: Plasma profiling of specific metabolites related to pyrimidine and tryptophan pathways can be used to differentiate whole-body radiation injury and dose response. As the tryptophan-associated indole compounds have their origin in the intestinal microbiome and subsequently the liver, these metabolites particularly represent an attractive marker for radiation injury within blood plasma

  15. Intestinal Microbiota-Derived Metabolomic Blood Plasma Markers for Prior Radiation Injury

    Energy Technology Data Exchange (ETDEWEB)

    Ó Broin, Pilib [Department of Genetics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Department of Mathematical Sciences, Yeshiva University, New York, New York (United States); Vaitheesvaran, Bhavapriya [Department of Medicine, Diabetes Center, Stable Isotope and Metabolomics Core Facility, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Saha, Subhrajit [Department of Radiation Oncology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Hartil, Kirsten [Department of Medicine, Diabetes Center, Stable Isotope and Metabolomics Core Facility, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Chen, Emily I. [Department of Pharmacology, Proteomics Shared Resource, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York (United States); Goldman, Devorah; Fleming, William Harv [Department of Medicine, Oregon Health and Science University, Portland, Oregon (United States); Kurland, Irwin J. [Department of Medicine, Diabetes Center, Stable Isotope and Metabolomics Core Facility, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Guha, Chandan, E-mail: cguha@montefiore.org [Department of Radiation Oncology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Golden, Aaron, E-mail: aaron.golden@einstein.yu.edu [Department of Genetics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Department of Mathematical Sciences, Yeshiva University, New York, New York (United States)

    2015-02-01

    Purpose: Assessing whole-body radiation injury and absorbed dose is essential for remediation efforts following accidental or deliberate exposure in medical, industrial, military, or terrorist incidents. We hypothesize that variations in specific metabolite concentrations extracted from blood plasma would correlate with whole-body radiation injury and dose. Methods and Materials: Groups of C57BL/6 mice (n=12 per group) were exposed to 0, 2, 4, 8, and 10.4 Gy of whole-body gamma radiation. At 24 hours after treatment, all animals were euthanized, and both plasma and liver biopsy samples were obtained, the latter being used to identify a distinct hepatic radiation injury response within plasma. A semiquantitative, untargeted metabolite/lipid profile was developed using gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry, which identified 354 biochemical compounds. A second set of C57BL/6 mice (n=6 per group) were used to assess a subset of identified plasma markers beyond 24 hours. Results: We identified a cohort of 37 biochemical compounds in plasma that yielded the optimal separation of the irradiated sample groups, with the most correlated metabolites associated with pyrimidine (positively correlated) and tryptophan (negatively correlated) metabolism. The latter were predominantly associated with indole compounds, and there was evidence that these were also correlated between liver and plasma. No evidence of saturation as a function of dose was observed, as has been noted for studies involving metabolite analysis of urine. Conclusions: Plasma profiling of specific metabolites related to pyrimidine and tryptophan pathways can be used to differentiate whole-body radiation injury and dose response. As the tryptophan-associated indole compounds have their origin in the intestinal microbiome and subsequently the liver, these metabolites particularly represent an attractive marker for radiation injury within blood plasma.

  16. Intestinal microbiota-derived metabolomic blood plasma markers for prior radiation injury.

    Science.gov (United States)

    Ó Broin, Pilib; Vaitheesvaran, Bhavapriya; Saha, Subhrajit; Hartil, Kirsten; Chen, Emily I; Goldman, Devorah; Fleming, William Harv; Kurland, Irwin J; Guha, Chandan; Golden, Aaron

    2015-02-01

    Assessing whole-body radiation injury and absorbed dose is essential for remediation efforts following accidental or deliberate exposure in medical, industrial, military, or terrorist incidents. We hypothesize that variations in specific metabolite concentrations extracted from blood plasma would correlate with whole-body radiation injury and dose. Groups of C57BL/6 mice (n=12 per group) were exposed to 0, 2, 4, 8, and 10.4 Gy of whole-body gamma radiation. At 24 hours after treatment, all animals were euthanized, and both plasma and liver biopsy samples were obtained, the latter being used to identify a distinct hepatic radiation injury response within plasma. A semiquantitative, untargeted metabolite/lipid profile was developed using gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry, which identified 354 biochemical compounds. A second set of C57BL/6 mice (n=6 per group) were used to assess a subset of identified plasma markers beyond 24 hours. We identified a cohort of 37 biochemical compounds in plasma that yielded the optimal separation of the irradiated sample groups, with the most correlated metabolites associated with pyrimidine (positively correlated) and tryptophan (negatively correlated) metabolism. The latter were predominantly associated with indole compounds, and there was evidence that these were also correlated between liver and plasma. No evidence of saturation as a function of dose was observed, as has been noted for studies involving metabolite analysis of urine. Plasma profiling of specific metabolites related to pyrimidine and tryptophan pathways can be used to differentiate whole-body radiation injury and dose response. As the tryptophan-associated indole compounds have their origin in the intestinal microbiome and subsequently the liver, these metabolites particularly represent an attractive marker for radiation injury within blood plasma. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Effect of heme oxygenase-1 on radiation-induced skin injury

    International Nuclear Information System (INIS)

    Song Chuanjun; Meng Xingjun; Xie Ling; Chen Qing; Zhou Jundong; Zhang Shuyu; Wu Jinchang

    2012-01-01

    Objective: To investigate the effect of heme oxygenase-1 (HO-1) on the acute radiation-induced skin injury by gene transfer. Methods: Thirty-three male SD rats were randomly divided into three groups as PBS-injected group, Ad-EGFP-injected group and Ad-HO-1-injected group (n=11). In each group, three rats were used for determining the expression of target gene and the other rats were irradiated on the buttock skin with 40 Gy electron beam generated by a linear accelerator. Immediately after irradiation, rats were administered with a subcutaneous injection of PBS, Ad-EGFP or Ad-HO-1, respectively. Subsequently, the skin reactions were measured twice a week using the semi-quantitative skin injury scale. Results: The strong positive expression of HO-1 was observed in subcutaneous dermal tissue after injection of Ad-HO-1. Compared to the PBS-injected group or the Ad-EGFP-injected group, a significant mitigation of skin injury was observed in Ad-HO-1-injected mice 14 d after irradiation (q=0.000-0.030, P<0.05). Conclusions: HO-1 could significantly mitigate radiation-induced acute skin injury and Ad-HO-1 could be used to treat radiation-induced skin injury. (authors)

  18. Delayed radiation injury of brain stem after radiotherapy in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Yang Yunli; Liu Yingxin; Xie Dong; Su Danke; Chen Mingzhong

    2002-01-01

    Objective: To study the clinical characteristics, MRI findings, diagnosis, treatment and prognostic factors of patients with radiation induced brain stem injury in nasopharyngeal carcinoma. Methods: From January 1991 to January 2001, 24 patients with radiation injury of brain stem were treated, 14 males and 10 females. The latency ranged from 6 to 38 months, with a median of 18 months. The lesions were located in the pons in 10 patients, mesencephalon + pons in 4, pons + medulla oblongata in 5, medulla oblongata in 2 and mesencephalon + pons + medulla oblongata in 3. MRI findings showed that the injury was chiefly presented as hypointensity foci on T 1 WI and hyperintensity foci on T 2 WI. Results: Eighteen patients were treated with dexamethasone in the early phase, with symptoms relieved in 12 patients but unimproved in 6 patients. Eight 44% patients died within the 8-38 months, leaving 16 patients surviving for 0.5 to 6.0 years. Conclusions: Radiation injury of brain stem has a short latency with severe symptoms, signifying poor prognosis. It is suggested that adequate reduction of irradiation volume and dose at the brain stem should be able to lower the incidence of brain stem injury

  19. Specificity and sensitivity of NMR based urinary metabolic biomarker for radiation injury

    International Nuclear Information System (INIS)

    Tyagi, Ritu; Watve, Apurva; Khushu, Subash; Rana, Poonam

    2016-01-01

    Increasing burden of natural background radiation and terrestrial radionuclides is a big threat of radiation exposure to the population at large. It is necessary to develop biomarker of ionizing radiation exposure that can be used for mass screening in the event of a radiological mass casualty incident. Metabolomics has already been proven as an excellent developing prospect for capturing diseases specific metabolic signatures as possible biomarkers. The aim of the present study is to evaluate the sensitivity and specificity of the urinary metabolites after whole body radiation exposure which can further be used as early predictive marker. The PLS-DA based ROC curve depicted taurine as a biomarker of early radiation injury. This study along with other 'omics' technique will be useful to help design strategies for non-invasive radiation biodosimetry through metabolomics in human populations

  20. [Studies on chemical protectors against radiation. XXXII. Protective effects of methanol extracts of various Taiwan crude drugs on radiation injuries].

    Science.gov (United States)

    Wang, C M; Ohta, S; Shinoda, M

    1990-11-01

    This study is to investigate radioprotective effects of 23 Taiwan crude drugs on X-ray induced bone marrow death and skin injury in mice. Each methanol extract of these Taiwan crude drugs was injected intraperitoneally into ICR male mice at 6 weeks of age before irradiation. Mice were whole-body irradiated with a soft X-ray generator. Radiation factors of the two screening tests used were as follows: 70 kVp, 10 mA, 10 mm acrylate filter, 70R/min, 2100R for survival test, and 30 kVp, 10 mA, 190R/min, 1100R for protective test on skin injury. As a result of these studies, the survival effect was recognized in Solani Incani Herba and Orthosiphi Aristati Herba. On the other hand, Mimosae Herba, Canarii Radix, Bombacis Radix, Arecae Fructus, Hedyotidis Diffusae Herba and Cynomorii Caulis were shown to have significant protective potency on skin injury.

  1. Factors Predictive of Symptomatic Radiation Injury After Linear Accelerator-Based Stereotactic Radiosurgery for Intracerebral Arteriovenous Malformations

    Energy Technology Data Exchange (ETDEWEB)

    Herbert, Christopher, E-mail: cherbert@bccancer.bc.ca [Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC (Canada); Moiseenko, Vitali [Department of Medical Physics, British Columbia Cancer Agency, Vancouver, BC (Canada); McKenzie, Michael [Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC (Canada); Redekop, Gary [Division of Neurosurgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC (Canada); Hsu, Fred [Department of Radiation Oncology, British Columbia Cancer Agency, Abbotsford, BC (Canada); Gete, Ermias; Gill, Brad; Lee, Richard; Luchka, Kurt [Department of Medical Physics, British Columbia Cancer Agency, Vancouver, BC (Canada); Haw, Charles [Division of Neurosurgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC (Canada); Lee, Andrew [Department of Neurosurgery, Royal Columbian Hospital, New Westminster, BC (Canada); Toyota, Brian [Division of Neurosurgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC (Canada); Martin, Montgomery [Department of Medical Imaging, British Columbia Cancer Agency, Vancouver, BC (Canada)

    2012-07-01

    Purpose: To investigate predictive factors in the development of symptomatic radiation injury after treatment with linear accelerator-based stereotactic radiosurgery for intracerebral arteriovenous malformations and relate the findings to the conclusions drawn by Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC). Methods and Materials: Archived plans for 73 patients who were treated at the British Columbia Cancer Agency were studied. Actuarial estimates of freedom from radiation injury were calculated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used for analysis of incidence of radiation injury. Log-rank test was used to search for dosimetric parameters associated with freedom from radiation injury. Results: Symptomatic radiation injury was exhibited by 14 of 73 patients (19.2%). Actuarial rate of symptomatic radiation injury was 23.0% at 4 years. Most patients (78.5%) had mild to moderate deficits according to Common Terminology Criteria for Adverse Events, version 4.0. On univariate analysis, lesion volume and diameter, dose to isocenter, and a V{sub x} for doses {>=}8 Gy showed statistical significance. Only lesion diameter showed statistical significance (p < 0.05) in a multivariate model. According to the log-rank test, AVM volumes >5 cm{sup 3} and diameters >30 mm were significantly associated with the risk of radiation injury (p < 0.01). The V{sub 12} also showed strong association with the incidence of radiation injury. Actuarial incidence of radiation injury was 16.8% if V{sub 12} was <28 cm{sup 3} and 53.2% if >28 cm{sup 3} (log-rank test, p = 0.001). Conclusions: This study confirms that the risk of developing symptomatic radiation injury after radiosurgery is related to lesion diameter and volume and irradiated volume. Results suggest a higher tolerance than proposed by QUANTEC. The widely differing findings reported in the literature, however, raise considerable uncertainties.

  2. Factors Predictive of Symptomatic Radiation Injury After Linear Accelerator-Based Stereotactic Radiosurgery for Intracerebral Arteriovenous Malformations

    International Nuclear Information System (INIS)

    Herbert, Christopher; Moiseenko, Vitali; McKenzie, Michael; Redekop, Gary; Hsu, Fred; Gete, Ermias; Gill, Brad; Lee, Richard; Luchka, Kurt; Haw, Charles; Lee, Andrew; Toyota, Brian; Martin, Montgomery

    2012-01-01

    Purpose: To investigate predictive factors in the development of symptomatic radiation injury after treatment with linear accelerator–based stereotactic radiosurgery for intracerebral arteriovenous malformations and relate the findings to the conclusions drawn by Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC). Methods and Materials: Archived plans for 73 patients who were treated at the British Columbia Cancer Agency were studied. Actuarial estimates of freedom from radiation injury were calculated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used for analysis of incidence of radiation injury. Log–rank test was used to search for dosimetric parameters associated with freedom from radiation injury. Results: Symptomatic radiation injury was exhibited by 14 of 73 patients (19.2%). Actuarial rate of symptomatic radiation injury was 23.0% at 4 years. Most patients (78.5%) had mild to moderate deficits according to Common Terminology Criteria for Adverse Events, version 4.0. On univariate analysis, lesion volume and diameter, dose to isocenter, and a V x for doses ≥8 Gy showed statistical significance. Only lesion diameter showed statistical significance (p 5 cm 3 and diameters >30 mm were significantly associated with the risk of radiation injury (p 12 also showed strong association with the incidence of radiation injury. Actuarial incidence of radiation injury was 16.8% if V 12 was 3 and 53.2% if >28 cm 3 (log–rank test, p = 0.001). Conclusions: This study confirms that the risk of developing symptomatic radiation injury after radiosurgery is related to lesion diameter and volume and irradiated volume. Results suggest a higher tolerance than proposed by QUANTEC. The widely differing findings reported in the literature, however, raise considerable uncertainties.

  3. Future directions in therapy of whole body radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Cronkite, E.P.

    1989-01-01

    Clinicians have long known that marked granulocytopenia predisposed patients to bacterial infections either from pathogens or commensal organisms with which an individual usually lives in harmony. Evidence that infection was of major importance derives from several observations: (a) clinical observations of bacterial infection in human beings exposed to atomic bomb radiation in Hiroshima and Nagasaki, in reactor accidents, and in large animals dying from radiation exposure, (b) correlative studies on mortality rate, time of death, and incidence of positive culture in animals, (c) challenge of irradiated animals with normally non-virulent organisms, (d) studies of germ free mice and rats, and (e) studies of the effectiveness of antibiotics in reducing mortality rate. General knowledge and sound experimental data on animals and man clearly demonstrated that the sequelae of pancytopenia (bacterial infection, thrombopenic hemorrhage, and anemia) are the lethal factors. A lot of research was required to demonstrate that there were no mysterious radiations toxins, that hyperheparinemia was not a cause of radiation hemorrhage and that radiation hemorrhage could be prevented by fresh platelet transfusions.

  4. Future directions in therapy of whole body radiation injury

    International Nuclear Information System (INIS)

    Cronkite, E.P.

    1989-01-01

    Clinicians have long known that marked granulocytopenia predisposed patients to bacterial infections either from pathogens or commensal organisms with which an individual usually lives in harmony. Evidence that infection was of major importance derives from several observations: (a) clinical observations of bacterial infection in human beings exposed to atomic bomb radiation in Hiroshima and Nagasaki, in reactor accidents, and in large animals dying from radiation exposure, (b) correlative studies on mortality rate, time of death, and incidence of positive culture in animals, (c) challenge of irradiated animals with normally non-virulent organisms, (d) studies of germ free mice and rats, and (e) studies of the effectiveness of antibiotics in reducing mortality rate. General knowledge and sound experimental data on animals and man clearly demonstrated that the sequelae of pancytopenia (bacterial infection, thrombopenic hemorrhage, and anemia) are the lethal factors. A lot of research was required to demonstrate that there were no mysterious radiations toxins, that hyperheparinemia was not a cause of radiation hemorrhage and that radiation hemorrhage could be prevented by fresh platelet transfusions

  5. Improvement of biological decontamination, protective and repair activity against radiation injury

    International Nuclear Information System (INIS)

    Kagawa, Yasuo

    2013-01-01

    Because the protection of human subject from late radiation injury is the final goal of remediation of radioactive contamination of 137 Cs in environment, improvement of DNA-repairing ability and 137 Cs-removal from human body is important. In order to reduce environmental radioactivity in areas exceeding 5 mSv/year in Fukushima prefecture, the cost is estimated to be 118 trillion yen, and there are difficulties in finding place to store 137 Cs-contaminated soils and in 137 Cs-recontamination. The radiation damage of DNA molecule takes place stochastically following linear no threshold model (LNT), but the cancer risk and other late radiation injury from long-term low dose radiation do not follow LNT model if we improve DNA repair and the cell regeneration systems. Indirect effects of radiation damage on DNA mediated by reactive oxygen species (ROS) are prevented by vitamin C, E, carotenoids including lycopene and phytochemicals. ROS is also removed by superoxide dismutases containing Cu, Mn and Z. Direct effects of radiation damage on DNA are repaired by enzyme systems using folic acid, vitamins B 6 and B 12 . In addition, before the radiation injury, absorption of 137 Cs is prevented by taking pectin etc. and excretion of 137 Cs is accelerated by ingesting more K. Finally, early detection of cancer and its removal by detailed health check of radiation-exposed people is needed. Radiation-protecting diet developed to protect astronauts from about 1 mSv per day, will be useful for many workers of atomic power plant as well as people living in the 137 Cs-contaminated areas. (author)

  6. Radiologic findings of thoracic trauma

    Directory of Open Access Journals (Sweden)

    Akgul Ozmen C

    2017-08-01

    Full Text Available Cihan Akgul Ozmen,1 Serdar Onat,2 Delal Aycicek3 1Department of Radiology, 2Department of Chest Surgery, Dicle University School of Medicine, Diyarbakir, 3Radiology Unit, Siirt State Hospital, Siirt, Turkey Introduction: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. Methods: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included. Most of the patients were male (83.3% and victims of a blunt chest trauma. The images were analyzed with respect to the presence of fractures of bony structures, hemothorax, pneumothorax, mediastinal organ injury, and pulmonary and vascular injuries. Results: MDCT images of the 240 patients yielded a prevalence of 41.7% rib fractures, 11.2% scapular fractures, and 7.5% clavicle fractures. The prevalence of thoracic vertebral fracture was 13.8% and that of sternal fracture was 3.8%. The prevalence of hemothorax, pneumothorax, pneumomediastinum, and subcutaneous emphysema was 34.6%, 62.1%, 9.6%, and 35.4%, respectively. The prevalence of rib, clavicle, and thoracic vertebral fractures and pulmonary contusion was higher in the blunt trauma group, whereas the prevalence of hemothorax, subcutaneous emphysema, diaphragmatic injury, and other vascular lacerations was significantly higher in the penetrating trauma group than in the blunt trauma group (p<0.05. Conclusion: MDCT images may yield a high prevalence of fracture of bony structures, soft tissue lacerations, and vascular lesions, which should be well understood by

  7. Surgical therapy for injuries of bowels by radiation

    International Nuclear Information System (INIS)

    Yamada, Akiyoshi; Sasaki, Hiroaki; Oomori, Naofumi; Hamano, Kyoichi; Kobayashi, Seiichiro

    1980-01-01

    A group of patients with damage of the GI tract by therapeutic irradiation for intra-abdominal neoplasma such as the carcinoma of uterus and rectum has been presented. With regard to the location of radiation damage, 32 cases of them are limited in the recto-sigmoid colon, 3 cases in the small bowel and 4 cases in both bowels. Among 19 cases who underwent an operation, radiation damage was found in the colon of 12 cases. Colostomy was made in all cases and in 2 cases colon resection was also performed. If radiation damage is noticed only in the rectum, colostomy is good indicated except for the cases in which a massive bleeding is seen. As to small bowel damages, if the symptoms of patient do not respond to the conservative treatment, operative intervention is necessary. At operation, the surgeon should be aware of the risks involved in performing adhesiolysis. (author)

  8. SU-F-T-622: Comparative Analysis of Pencil Beam and Anisotropic Analytical Algorithm (AAA) for Stereotactic Body Radiation Therapy (SBRT) of Thoracic Spine

    Energy Technology Data Exchange (ETDEWEB)

    Badkul, R; Nicolai, W; Pokhrel, D; Jiang, H; Wang, F; Lominskac, C [University of Kansas Medical Center, Kansas City, KS (United States); Ramanjappa, T [S. K. University, Anantapur, AP (India)

    2016-06-15

    Purpose: To compare the impact of Pencil Beam(PB) and Anisotropic Analytic Algorithm(AAA) dose calculation algorithms on OARs and planning target volume (PTV) in thoracic spine stereotactic body radiation therapy (SBRT). Methods: Ten Spine SBRT patients were planned on Brainlab iPlan system using hybrid plan consisting of 1–2 non-coplanar conformal-dynamic arcs and few IMRT beams treated on NovalisTx with 6MV photon. Dose prescription varied from 20Gy to 30Gy in 5 fractions depending on the situation of the patient. PB plans were retrospectively recalculated using the Varian Eclipse with AAA algorithm using same MUs, MLC pattern and grid size(3mm).Differences in dose volume parameters for PTV, spinal cord, lung, and esophagus were analyzed and compared for PB and AAA algorithms. OAR constrains were followed per RTOG-0631. Results: Since patients were treated using PB calculation, we compared all the AAA DVH values with respect to PB plan values as standard, although AAA predicts the dose more accurately than PB. PTV(min), PTV(Max), PTV(mean), PTV(D99%), PTV(D90%) were overestimated with AAA calculation on average by 3.5%, 1.84%, 0.95%, 3.98% and 1.55% respectively as compared to PB. All lung DVH parameters were underestimated with AAA algorithm mean deviation of lung V20, V10, V5, and 1000cc were 42.81%,19.83%, 18.79%, and 18.35% respectively. AAA overestimated Cord(0.35cc) by mean of 17.3%; cord (0.03cc) by 12.19% and cord(max) by 10.5% as compared to PB. Esophagus max dose were overestimated by 4.4% and 5cc by 3.26% for AAA algorithm as compared to PB. Conclusion: AAA overestimated the PTV dose values by up to 4%.The lung DVH had the greatest underestimation of dose by AAA versus PB. Spinal cord dose was overestimated by AAA versus PB. Given the critical importance of accuracy of OAR and PTV dose calculation for SBRT spine, more accurate algorithms and validation of calculated doses in phantom models are indicated.

  9. Methods for assessing the extent of acute radiation injury

    International Nuclear Information System (INIS)

    Fliedner, T.M.

    1996-01-01

    Previous radiation accidents have shown that the medical management of exposed persons cannot be performed without the use of 'biological indicators' of effect and of repair. For the clinical management of a patient with the acute radiation syndrome, it is essential to obtain information on the subjective symptomatology as well as on laboratory parameters, especially during the first 3 to 6 days after exposure. The medical doctor responsible for the clinical care of patients has to rely on the use of what has been described as 'sequential diagnosis'. This approach consists essentially of the determination of a limited number of parameters as a function of time. From the analysis of the pattern of the determined and evaluated signs and symptoms in the first hours and days, one is able to characterize patients according to type and severity of symptomatology. This has been clearly demonstrated in the Moscow - Ulm Radiation Accident Database (MURAD) developed in a collaborative project between the Institute of Biophysics in Moscow and the Department of Clinical Physiology and Occupational Medicine of the University of Ulm. On the basis of the radiation accident clinical response pattern observed early after irradiation, one is able to develop a first approach for therapeutic strategies. It is the purpose of this contribution to outline the diagnostic and prognostic significance of blood cell changes and to discuss the following problem areas: significance and elements of a sequential diagnosis; significance of blood lymphocytes for radiation accident diagnosis; significance of blood granulocyte changes for the prognosis of the acute radiation syndrome; analysis of granulocyte changes by means of regulated system models; utilization of indicators of response and repair for planning therapeutic options

  10. Comparative evaluation of radiation injuries in skin histological structures under local irradiation

    International Nuclear Information System (INIS)

    Kolchanova, G.M.

    1978-01-01

    In order to evaluate quantitatively to what degree the various histologic structures of the skin undergo changes after a radiation injury and during the reparative process, white rats have been used to study these changes in relation to the radiation dose and the time elapsed after exposure. The rats have been locally exposed on a single occasion to long-wave (10.2 keV) x-radiation in doses of 250, 500, 1000, or 2000 R. Greatest changes in histologic structures occured with doses of 250-1000 R on days 96-115 postexposure. With higher doses, these changes are most clearly marked as early as on day 38

  11. Alpha-tocopherol succinate- and AMD3100-mobilized progenitors mitigate radiation combined injury in mice

    International Nuclear Information System (INIS)

    Singh, Vijay K.; Wise, Stephen Y.; Fatanmi, Oluseyi O.; Beattie, Lindsay A.; Ducey, Elizabeth J.; Seed, Thomas M.

    2014-01-01

    The purpose of this study was to elucidate the role of alpha-tocopherol succinate (TS)- and AMD3100-mobilized progenitors in mitigating combined injury associated with acute radiation exposure in combination with secondary physical wounding. CD2F1 mice were exposed to high doses of cobalt-60 gamma-radiation and then transfused intravenously with 5 million peripheral blood mononuclear cells (PBMCs) from TS- and AMD3100-injected mice after irradiation. Within 1 h after irradiation, mice were exposed to secondary wounding. Mice were observed for 30 d after irradiation and cytokine analysis was conducted by multiplex Luminex assay at various time-points after irradiation and wounding. Our results initially demonstrated that transfusion of TS-mobilized progenitors from normal mice enhanced survival of acutely irradiated mice exposed 24 h prior to transfusion to supralethal doses (11.5–12.5 Gy) of 60 Co gamma-radiation. Subsequently, comparable transfusions of TS-mobilized progenitors were shown to significantly mitigate severe combined injuries in acutely irradiated mice. TS administered 24 h before irradiation was able to protect mice against combined injury as well. Cytokine results demonstrated that wounding modulates irradiation-induced cytokines. This study further supports the conclusion that the infusion of TS-mobilized progenitor-containing PBMCs acts as a bridging therapy in radiation-combined-injury mice. We suggest that this novel bridging therapeutic approach involving the infusion of TS-mobilized hematopoietic progenitors following acute radiation exposure or combined injury might be applicable to humans. (author)

  12. Thoracic myelopathy with alkaptonuria.

    Science.gov (United States)

    Akeda, Koji; Kasai, Yuichi; Kawakita, Eiji; Matsumura, Yoshihiro; Kono, Toshibumi; Murata, Tetsuya; Uchida, Atsumasa

    2008-01-15

    A case of thoracic myelopathy with alkaptonuria (ochronotic spondyloarthropathy) is presented. To present and review the first reported case of an alkaptonuric patient with concomitant thoracic myelopathy. Alkaptonuria, a rare hereditary metabolic disease, is characterized by accumulation of homogentistic acid, ochronosis, and destruction of connective tissue resulting in degenerative spondylosis and arthritis. Despite the high incidence of intervertebral disc diseases among patients with alkaptonuria, neurologic symptoms caused by spinal disease are rare. Thoracic myelopathy in a patient with alkaptonuria has not been previously reported. The clinical course, radiologic features, pathology, and treatment outcome of an alkaptonuria patient with thoracic myelopathy was documented. Myelopathy of the patient was caused by rupture of a thoracic intervertebral disc. The neurologic symptoms of the patient were markedly improved after surgery. We have reported for the first time, that an alkaptonuria patient showed thoracic myelopathy caused by rupture of a thoracic intervertebral disc. Decompression followed by the instrumented fusion of the thoracic spine was effective for improving the neurologic symptoms.

  13. Radiation Combined Injury: DNA Damage, Apoptosis, and Autophagy

    Science.gov (United States)

    2010-01-01

    TLR signaling, cytokine concentrations, bacterial infection, and cytochrome c release from mitochondria to cyto- plasm . These alterations lead to...eject electrons from their outer orbits. In considering the effects of radiation on biological systems, it is important to distinguish the different

  14. Combined Injury Modeling: Radiation and Burn Workshop Report

    Science.gov (United States)

    2010-10-01

    the effects manifest from 6-12 months post exposure, which is later than the lung and GI effects. Liver effects may also play a prominent role...when radiation exposure is combined with burn. For instance, in the Chernobyl accident, hepatic encephalopathy was a major cause of death in patients

  15. Ultrasound appearance of radiation-induced hepatic injury. Correlation with computed tomography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Garra, B.S.; Shawker, T.H.; Chang, R.; Kaplan, K.; White, R.D.

    1988-01-01

    The ultrasound findings in three cases of radiation-induced hepatic injury are described and compared with computed tomography and magnetic resonance imaging findings. Fatty infiltration of the liver was present in two of the cases in which concurrent chemotherapy was being administered. On ultrasound B-scans, the regions of radiation injury were hypoechoic relative to the remainder of the liver. This finding was more obvious in the patients with fatty livers. CT scans on the patients with fatty infiltrated livers showed higher attenuation in the irradiated region than in unexposed liver. In the patient where no fatty infiltration was present, the radiated section of liver had lower attenuation consistent with previous reports. Magnetic resonance imaging showed decreased signal in the exposed areas on T1 weighted images

  16. Biological dosimetry in case of combined radiation injuries. Biologicheskaya dozimetriya pri kombinirovannykh radiatsionnykh porazheniyakh

    Energy Technology Data Exchange (ETDEWEB)

    Vladimirov, V G; Teslenko, V M

    1990-11-01

    The state of biological dosimetry methods and prospects for their development are considered. Attention is paid to biological indicators of radiation injuries caused by nuclear weapons. It is noted, that determination of the number of lymphocytes in the blood in case of combined radiation injuries should be concerned with great care and in each case the analysis results should reffered to critically and supported by the data from other investigations. Promissing are the methods related to dermination of reticulocyte number in the peripheral blood within the irradiation dose range, causing bone marrow form of radiation syndrome, method of leukocyte adhesion and some other methods based on the change of biophysical caracteristics of cell membranes. To increase the information efficiency it is necessary to combine these methods with the methods, based on genetic change registration, and to develop a combined method.

  17. Pyruvate metabolism: A therapeutic opportunity in radiation-induced skin injury

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Hyun; Kang, Jeong Wook [Department of Radiation Oncology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Lee, Dong Won [Department of Plastic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Oh, Sang Ho [Department of Dermatology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Lee, Yun-Sil [College of Pharmacy & Division of Life and Pharmaceutical Sciences, Ewah Womans University, Seoul 120-750 (Korea, Republic of); Lee, Eun-Jung [Department of Radiation Oncology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Cho, Jaeho, E-mail: jjhmd@yuhs.ac [Department of Radiation Oncology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 (Korea, Republic of)

    2015-05-08

    Ionizing radiation is used to treat a range of cancers. Despite recent technological progress, radiation therapy can damage the skin at the administration site. The specific molecular mechanisms involved in this effect have not been fully characterized. In this study, the effects of pyruvate, on radiation-induced skin injury were investigated, including the role of the pyruvate dehydrogenase kinase 2 (PDK2) signaling pathway. Next generation sequencing (NGS) identified a wide range of gene expression differences between the control and irradiated mice, including reduced expression of PDK2. This was confirmed using Q-PCR. Cell culture studies demonstrated that PDK2 overexpression and a high cellular pyruvate concentration inhibited radiation-induced cytokine expression. Immunohistochemical studies demonstrated radiation-induced skin thickening and gene expression changes. Oral pyruvate treatment markedly downregulated radiation-induced changes in skin thickness and inflammatory cytokine expression. These findings indicated that regulation of the pyruvate metabolic pathway could provide an effective approach to the control of radiation-induced skin damage. - Highlights: • The effects of radiation on skin thickness in mice. • Next generation sequencing revealed that radiation inhibited pyruvate dehydrogenase kinase 2 expression. • PDK2 inhibited irradiation-induced cytokine gene expression. • Oral pyruvate treatment markedly downregulated radiation-induced changes in skin thickness.

  18. Injury of the blood-testies barrier after low-dose-rate chronic radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Young Hoon; Bae Min Ji; Lee, Chang Geun; Yang, Kwang Mo; Jur, Kyu; Kim, Jong Sun [Dongnam Institute of Radiological and Medical Science, Busan (Korea, Republic of)

    2014-04-15

    The systemic effect of radiation increases in proportionally with the dose and dose rate. Little is known concerning the relationships between harmful effects and accumulated dose, which is derived from continuous low-dose rate radiation exposure. Recent our studies show that low-dose-rate chronic radiation exposure (3.49 mGy/h) causes adverse effects in the testis at a dose of 2 Gy (6 mGy/h). However, the mechanism of the low-dose-rate 2 Gy irradiation induced testicular injury remains unclear. The present results indicate that low-dose rate chronic radiation might affect the BTB permeability, possibly by decreasing levels of ZO-1, Occludin-1, and NPC-2. Furthermore, our results suggest that there is a risk of male infertility through BTB impairment even with low-dose-rate radiation if exposure is continuous.

  19. Patient's quality of life after high-dose radiation therapy for thoracic carcinomas. Changes over time and influence on clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, Christina [University Clinic Giessen and Marburg, Clinic for Radiotherapy and Radiation Oncology, Marburg (Germany); Ruppiner Kliniken GmbH, Clinic for Radiotherapy and Radiation Oncology, Neuruppin (Germany); Engenhart-Cabillic, Rita; Vorwerk, Hilke [University Clinic Giessen and Marburg, Clinic for Radiotherapy and Radiation Oncology, Marburg (Germany); Schmidt, Michael; Huhnt, Winfried; Blank, Eyck; Sidow, Dietrich; Buchali, Andre [Ruppiner Kliniken GmbH, Clinic for Radiotherapy and Radiation Oncology, Neuruppin (Germany)

    2017-02-15

    Quality of life (QoL) is an important factor in patient care. This analysis is focused on QoL before and after radio(chemo)therapy in patients with thoracic carcinomas, as well as on its influence on clinical follow-up and survival, and the correlation with treatment-related toxicities. The analysis included 81 patients with intrathoracic carcinoma receiving radio(chemo)therapy. For analysis of QoL, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the lung cancer-specific supplement (EORTC QLQ-LC13) were used. QoL data were collected before radiation treatment (RT), and 6 weeks, 12 weeks, 6 months, and 12 months after RT. Other factors were additionally analyzed, including clinical outcome, survival, and side effects. The functional scales showed maximum values or at least a recovery 12 weeks after RT. Symptoms with a high mean symptom score (> 40) at all appointments were fatigue, dyspnea, and coughing. Insomnia, peripheral neuropathy, appetite loss, dyspnea (from QLQ-LC13), and all pain parameters had an intermediate mean score (10-40). There were low mean scores of < 10 for nausea and vomiting, diarrhea, sore mouth, and hemoptysis. There was a significant correlation between clinical dysphagia and radiation pneumonitis with the associated symptom scales. None of the QoL scores had a significant influence on local and distant control or survival. 12 weeks after RT the QLQ-C30 functional scales show the highest scores or at least a temporary recovery. The symptom scales accurately reflect the common symptoms and treatment-related toxicities. QoL did not prove to be a significant predictor for local and distant control or survival. (orig.) [German] Die Lebensqualitaet (QoL) ist ein entscheidender Faktor in der Patientenversorgung. In der vorliegenden Untersuchung lag der Fokus auf der QoL vor und nach Radio(chemo)therapie von Patienten mit thorakalen Tumoren sowie deren Einfluss auf das klinische

  20. Therapy of radiation injuries of the rat marginal periodontium

    International Nuclear Information System (INIS)

    Lieske, W.; Stahlberg, N.

    1987-01-01

    The influence of different consistencies of food and of ionizing radiations on the marginal periodontium of female Wistar rats was studied. Microorganisms play an important part in the development of inflammatory histological reactions. Chlorhexidine and metronidazole treatment, resp., revealed a favourable effect on the inflammatory alterations of the periodontium. The evaluation was based on semiquantitative identification of plaques as well as on histological investigations of the interdental col and of the subepithelial connective tissue

  1. Possibilities and methods for biochemical assessment of radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Minkova, M [Meditsinska Akademiya, Sofia (Bulgaria). Nauchen Inst. po Rentgenologiya i Radiobiologiya

    1986-01-01

    An extensitive review (77 references) is made of the application of biochemical diagnostic methods for assessment of radiation diseases. A brief characteristics of several biochemical indicators is given: deoxycytidine, thymidine, rho-aminoisocarboxylic acid, DNA-ase, nucleic acids. Influence of such factors as age, sex, season etc. is studied by means of functional biochemical indicators as: creatine, triptophanic metabolites, 5-hydroxy-indolacetic acid, biogenic amines, serum proteins, enzymes, etc.

  2. Carcinoma of the thoracic esophagus

    International Nuclear Information System (INIS)

    Herskovic, A.M.; Leichman, L.; Lattin, P.B.

    1987-01-01

    The authors analyzed all cases of thoracic esophagel carcinoma seen from 1980 to 1984 inclusive, plus an additional 22 cases from a pilot study at Wayne State University. Most patients received preoperative combination radiation and chemotherapy. Eighty-nine patients completed treatment (5-fluorouracil, cisplatin, and radiation therapy) as in both the RTOG and SWOG national studies. Of these 89, 39 refused or were not offered planned surgery. Four patients are still alive and well. Fifty patients underwent esophagectomy; 12 patients were free of tumor at esophagectomy, and four of these are alive and well. One patient with a tumor in the resected esophagus alone is still alive. Twenty-two patients were enrolled in the pilot study in which surgery was reserved for salvage, the initial radiation volume was increased, the tumor dose was increased to 5,000 rad give continuously, and chemotherapy was increased to four courses

  3. [Safety and efficacy of percutaneous patent ductus arteriosus closure solely under thoracic echocardiography guidance].

    Science.gov (United States)

    Pan, Xiangbin; Ouyang, Wenbin; Li, Shoujun; Guo, Gaili; Liu, Yao; Zhang, Dawei; Zhang, Fengwen; Pang, Kunjing; Fang, Nengxin; Hu, Shengshou

    2015-01-01

    To avoid the radiation injuries and use of contrast agent, we assessed the safety and efficacy of percutaneous patent ductus arteriosus closure solely under thoracic echocardiography guidance. From June 2013 to June 2014, thirty patients (mean age: (6.3 ± 2.5) years, mean body weight:(22.5 ± 7.3) kg) with pure patent ductus arteriosus were continuously included in this study. The mean diameter of patent ductus arteriosus was (3.8 ± 0.9) mm. Patients were all treated by percutaneous patent ductus arteriosus closure via right femoral artery solely under thoracic echocardiography guidance. The efficacy of the procedure was evaluated by thoracic echocardiography. Follow-up was performed at one month after procedure. All 30 cases were successfully treated with percutaneous patent ductus arteriosus closure solely under thracic echocardiography guidance. The procedural time was (32.8 ± 5.7) minutes. The mean diameter of Amplatzer ADO II was (4.9 ± 1.0) mm. Postoperative trivial residual shunt occurred in six patients immediately after the procedure. All patients survived without peripheral vascular injury or complications such as cardiac perforation. Hospitalization time was (3.4 ± 0.7) days. At one-month follow-up, no complications such as residual shunt or pericardial effusion were observed. Echocardiography guided percutaneous patent ductus arteriosus closure by femoral artery approach is safe and effective, and can avoid X-ray and the use of contrast agents.

  4. Nicaraven attenuates radiation-induced injury in hematopoietic stem/progenitor cells in mice.

    Directory of Open Access Journals (Sweden)

    Miho Kawakatsu

    Full Text Available Nicaraven, a chemically synthesized hydroxyl radical-specific scavenger, has been demonstrated to protect against ischemia-reperfusion injury in various organs. We investigated whether nicaraven can attenuate radiation-induced injury in hematopoietic stem/progenitor cells, which is the conmen complication of radiotherapy and one of the major causes of death in sub-acute phase after accidental exposure to high dose radiation. C57BL/6 mice were exposed to 1 Gy γ-ray radiation daily for 5 days in succession (a total of 5 Gy, and given nicaraven or a placebo after each exposure. The mice were sacrificed 2 days after the last radiation treatment, and the protective effects and relevant mechanisms of nicaraven in hematopoietic stem/progenitor cells with radiation-induced damage were investigated by ex vivo examination. We found that post-radiation administration of nicaraven significantly increased the number, improved the colony-forming capacity, and decreased the DNA damage of hematopoietic stem/progenitor cells. The urinary levels of 8-oxo-2'-deoxyguanosine, a marker of DNA oxidation, were significantly lower in mice that were given nicaraven compared with those that received a placebo treatment, although the levels of intracellular and mitochondrial reactive oxygen species in the bone marrow cells did not differ significantly between the two groups. Interestingly, compared with the placebo treatment, the administration of nicaraven significantly decreased the levels of the inflammatory cytokines IL-6 and TNF-α in the plasma of mice. Our data suggest that nicaraven effectively diminished the effects of radiation-induced injury in hematopoietic stem/progenitor cells, which is likely associated with the anti-oxidative and anti-inflammatory properties of this compound.

  5. SU-F-T-106: A Dosimetric Study of Intensity Modulated Radiation Therapy to Decrease Radiation Dose to the Thoracic Vertebral Bodies in Patients Receiving Concurrent Chemoradiation for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    DiCostanzo, Dominic; Barney, Christian L.; Bazan, Jose G. [The Ohio State University, Columbus, Ohio (United States)

    2016-06-15

    Purpose: Recent clinical studies have shown a correlation between radiation dose to the thoracic vertebral bodies (TVB) and the development of hematologic toxicity (HT) in patients receiving chemoradiation (CRT) for lung cancer (LuCa). The feasibility of a bone-marrow sparing (BMS) approach in this group of patients is unknown. We hypothesized that radiation dose to the TVB can be reduced with an intensity modulated radiation therapy(IMRT)/volumetric modulated arc radiotherapy(VMAT) without affecting plan quality. Methods: We identified LuCa cases treated with curative intent CRT using IMRT/VMAT from 4/2009 to 2/2015. The TVBs from T1–T10 were retrospectively contoured. No constraints were placed on the TVB structure initially. A subset were re-planned with BMS-IMRT/VMAT with an objective or reducing the mean TVB dose to <23 Gy. The following data were collected on the initial and BMS plans: mean dose to planning target volume (PTV), lungs-PTV, esophagus, heart; lung V20; cord max dose. Pairwise comparisons were performed using the signed rank test. Results: 94 cases received CRT with IMRT/VMAT. We selected 11 cases (7 IMRT, 4 VMAT) with a range of initial mean TVB doses (median 35.7 Gy, range 18.9–41.4 Gy). Median prescription dose was 60 Gy. BMS-IMRT/VMAT significantly reduced the mean TVB dose by a median of 10.2 Gy (range, 1.0–16.7 Gy, p=0.001) and reduced the cord max dose by 2.9 Gy (p=0.014). BMS-IMRT/VMAT had no impact on lung mean (median +17 cGy, p=0.700), lung V20 (median +0.5%, p=0.898), esophagus mean (median +13 cGy, p=1.000) or heart mean (median +16 cGy, p=0.365). PTV-mean dose was not affected by BMS-IMRT/VMAT (median +13 cGy, p=0.653). Conclusion: BMS-IMRT/VMAT was able to significantly reduce radiation dose to the TVB without compromising plan quality. Prospective evaluation of BMS-IMRT/VMAT in patients receiving CRT for LuCa is warranted to determine if this approach results in clinically significant reductions in HT.

  6. Late radiation injury of the colon and rectum. Surgical management and outcome

    International Nuclear Information System (INIS)

    Kimose, H.H.; Fischer, L.; Spjeldnaes, N.; Wara, P.

    1989-01-01

    After a median latency of 2 years, the initial late colorectal radiation injuries in 182 patients were: stricture (37 percent), minor lesions (36 percent), rectovaginal fistula (22 percent), and gangrene or other fistulas (5 percent). Due to progression, new colorectal injuries, primarily stricture (55 percent) and fistula (42 percent), occurred in 68 patients (37 percent). Resection provided the best results. However, the resectability rate was low (46 percent) and resection was primarily performed in patients with a circumscript well-defined stricture of the proximal rectum or sigmoid colon with an anastomotic leakage rate of 5 percent. The prevailing management of 78 patients with fistula or stricture with synchronous fistula was defunctioning colostomy, primarily end-sigmoidostomy, providing fair results in half of the patients. Stomal complications occurred in 15 percent. The radiation-induced colorectal mortality was 8 percent. Colorectal fistula and associated radiation injuries of the urinary tract, and especially of the small bowel, were the major determinants of fatal outcome, yielding an overall radiation-induced mortality of 25 percent. After a median observation time of 13 years, half of the patients were alive at follow-up; 56 percent of these had a fair outcome whereas the remaining patients continued to have mild symptoms responding to conservative measures (34 percent) or disabling symptoms (10 percent)

  7. Possibilities for prognostication of radiation injury in rats by leucocyte nucleic acid levels

    International Nuclear Information System (INIS)

    Minkova, M.; Pantev, T.

    1988-01-01

    The possibilities to prognosticate acute radiation injury by the changes in the amount of nucleic acids in the leucocytes was studied. Experiments were carried out on male Wistar albino rats, gamma-irradiated with nonlethal and sublethal doses of 0.5, 2 and 4 Gy and lethal dose of 8 Gy (LD 90/30 ). The nucleic acid content and the total leucocyte count were determined at definite intervals on days 1-30. The changes in the nucleic acids in nonlethally and sublethally irradiated animals had phase nature, with a clear-cut abortive increase in their amount on days 7-10. In lethally irradiated animals the phase character of the changes was lost and the abortive peak disappeared. By reducing the effectiveness of the lethal radiation dose survival of the population increased from 10-75% through physical and from 10-70% - through chemical protection. The nucleic acid dynamics showed features typical for an injury with possible survival - appearance of abortive peak and resumption of their normal values. It is assumed that determination of leucocyte nucleic acid content may be used for early prognostication of radiation injury, as it allows keen differentiation of the lethal from nonlethal outcome of radiation sickness. The absence of abortive peak (over 50%) by day 14 post-irradiation is a poor prognostic sign

  8. Development of a guinea pig cutaneous radiation injury model using low penetrating X-rays.

    Science.gov (United States)

    Rodgers, Kathleen E; Tan, Alick; Kim, Lila; Espinoza, Theresa; Meeks, Christopher; Johnston, William; Maulhardt, Holly; Donald, Melissa; Hill, Colin; diZerega, Gere S

    2016-08-01

    A guinea pig skin model was developed to determine the dose-dependent response to soft X-ray radiation into the dermis. X-ray exposure (50 kVp) was defined to a 4.0 × 4.0 cm area on the lateral surface of a guinea pig using lead shielding. Guinea pigs were exposed to a single fraction of X-ray irradiation ranging from 25-79 Gy via an XRAD320ix Biological Irradiator with the collimator removed. Gross skin changes were measured using clinical assessments defined by the Kumar scale. Skin contracture was assessed, as well as histological evaluations. Loss of dermal integrity was shown after a single dose of soft X-ray radiation at or above 32 Gy with the central 2.0 × 2.0 cm of the exposed site being the most affected. Hallmarks of the skin injury included moist desquamation, ulceration and wound contracture, as well as alterations in epithelium, dermis, muscle and adipose. Changes in the skin were time- and radiation dose-dependent. Full-thickness injury occurred without animal mortality or gross changes in the underlying organs. The guinea pig is an appropriate small animal model for the short-term screening of countermeasures for cutaneous radiation injury (CRI).

  9. Explanation of the law on radiation injury prevention for mechanical engineers

    International Nuclear Information System (INIS)

    Fukuyama, Hiroyuki

    1991-01-01

    Generally to the facilities in which radioisotopes are treated, the Law on Radiation Injury Prevention is applied, but this law was revised in May, 1988, and enforced on April 1, 1989. As to the retroaction to existing facilities, the delay till March 31, 1991 is granted. In this report, by rearranging the system of contents so as to suit to mechanical engineers, the procedure of application and the standard for exhaust facilities and drainage facilities, which seem to be necessary matters, are described. In addition, the standard for facilities related to architecture which seems useful for design and construction if it is known as the basic matter and the standard for the control of the exposure of human bodies, surface contamination and measurement, related to the RI contamination in the air are referred to. The main points of revision in terms, unit and the law are shown. The Law on Radiation Injury Prevention is composed of the Law on Prevention of Radiation Injuries Due to Radioisotopes and Others, the enforcement ordinance, the enforcement regulation and the notice on determining the quantity of isotopes emitting radiation. (K.I.)

  10. Ileal perforation induced by acute radiation injury under gefitinib treatment

    International Nuclear Information System (INIS)

    Muraoka, Takayuki; Tsukuda, Kazunori; Toyooka, Shinichi

    2011-01-01

    Enteritis is one of the side effects of radiotherapy to the abdominal cavity. Radiation enteritis involves damage to mucous membranes in the acute phase and to stromal tissues in the late phase. Perforation of the intestine tends to occur in the late phase, and rarely in the acute phase. However, we describe here a case of intestinal perforation occurring in the acute phase after irradiation in a patient who received gefitinib treatment. Gefitinib, one of the epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), is widely used to treat non-small cell lung cancer (NSCLC) patients, but is simultaneously known to inhibit wound healing. We suspect that gefitinib may affect regeneration of the small intestinal mucosa injured by irradiation. A 76-year-old woman had NSCLC with metastases to the 5th lumbar, sacral, and right iliac bones. To control the pain from bone metastasis, anterior-posterior opposing portal irradiation (total 35 Gy) was started, and was completed over 22 days. On day 25 after starting radiotherapy, the patient began to take gefitinib. On day 35, she presented with acute peritonitis, and an emergency laparotomy was performed. The terminal ileum was affected by radiation enteritis and there were two pin-hole perforations. In the surgical specimen, no cancerous lesions were detected, and immunohistochemical staining of phosphorylated EGFR (pEGFR) was negative. pEGFR has an important role in mucous membrane repair after irradiation. Intestinal perforation in the acute phase of radiation enteritis may be associated with impaired mucosal repair mechanisms due to the use of an EGFR-TKI such as gefitinib, as evidenced by the absence of pEGFR. (author)

  11. Injuries to embryo and foetus from ionising radiation

    International Nuclear Information System (INIS)

    Devik, F.

    1980-01-01

    A brief review is given of experimental and clinical evidence for tetatological effects of ionising radiation, against the background of general teratology. International and national recommendations and regulations for the protection of the conceptus are quoted. As to interruption of a pregnancy following an unintended exposure, it is pointed out that much of the present evidence points to a dose in the order of 0.1Gy (10 rads) as a dose which may be considered as a practical threshold for the induction of congenital defects. (Auth.)

  12. Lesão oculta da articulação manúbrio-esternal associada à fratura da coluna torácica Occult manubriosternal joint injury associated with fracture of the thoracic spine

    Directory of Open Access Journals (Sweden)

    Carlos Fernando Pereira da Silva Herrero

    2011-04-01

    Full Text Available Os autores relatam a ocorrência de lesão oculta da articulação manúbrio-esternal na avaliação inicial de um paciente com fratura da coluna torácica (T9. Foi diagnosticada fratura de T9 no paciente do sexo masculino de 37 anos de idade associada a déficit neurológico parcial. No atendimento inicial, as radiografias realizadas não demonstraram a lesão da articulação manúbrioesternal. Durante a reabilitação, após a estabilização cirúrgica da fratura da coluna torácica, subitamente o paciente sentiu dor intensa, acompanhada de deformidade ao nível do esterno, tendo sido diagnosticada luxação manúbrio-esternal nos exames de imagem. Devido à recidiva da luxação e de dor incapacitante, foi necessária a realização da redução aberta e fixação da articulação manúbrio-esternal. Na avaliação após 12 meses, o paciente apresentou recuperação completa da lesão neurológica, consolidação da artrodese do segmento vertebral T7-T11, e manutenção da redução da articulação manúbrio-esternal, que era assintomática durante a realização das atividades cotidianas.The authors report the occurrence of an occult manubriosternal joint injury in the initial evaluation on a patient with a thoracic spine fracture (T9. This T9 fracture was diagnosed in a 37-year-old man and was associated with a partial neurological deficit. At the initial evaluation, the radiographs produced did not show the manubriosternal joint injury. During rehabilitation, after surgical stabilization of the thoracic spine fracture, the patient suddenly felt an intense pain accompanied by deformation at the sternal level. From imaging examinations, manubriosternal dislocation was diagnosed. Because of recurrence of the dislocation and the incapacitating pain, open reduction and fixation of the manubriosternal joint had to be performed. At the 12-month follow-up, the patient presented complete recovery of the neurological lesion, consolidation of the

  13. Endovascular repair of traumatic thoracic aortic tears.

    Science.gov (United States)

    Mansour, M Ashraf; Kirk, Jeffrey S; Cuff, Robert F; Banegas, Shonda L; Ambrosi, Gavin M; Liao, Timothy H; Chambers, Christopher M; Wong, Peter Y; Heiser, John C

    2012-03-01

    Patients with thoracic aorta injuries (TAI) present a unique challenge. The purpose of this study was to review the outcomes of thoracic endovascular aortic repair (TEVAR) in patients with TAI. A retrospective chart review of all patients admitted for TEVAR for trauma was performed. In a 5-year period, 19 patients (6 women and 13 men; average age, 42 y) were admitted to our trauma center with TAI. Mechanism of injury was a motor vehicle crash in 12 patients, motorcycle crash in 2 patients, automobile-pedestrian accident in 2 patients, 1 fall, 1 crush injury, and 1 stab wound to the back. A thoracic endograft was used in 6 patients and proximal aortic cuffs were used in 13 patients (68%). One patient (5%) died. There were no strokes, myocardial infarctions, paraplegia, or renal failure. TEVAR for TAI appears to be a safe option for patients with multiple injuries. TEVAR in young patients is still controversial because long-term endograft behavior is unknown. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. New strategies for the prevention of radiation injury. Possible implications for countering radiation hazards of long-term space travel

    International Nuclear Information System (INIS)

    Seed, T.; Kumar, S.; Whitnall, M.

    2002-01-01

    New strategies for the prevention of radiation injuries are currently being explored with the ultimate aim of developing globally radioprotective, nontoxic pharmacologics. The prophylactic treatments under review encompass such diverse pharmacologic classes as novel immunomodulators, nutritional antioxidants, and cytokines. An immunomodulator that shows promise is 5-androstenediol (AED), a well-tolerated, long-acting and rostene steroid with broad-spectrum radioprotective attributes that include not only protection against acute tissue injury, but also reduced susceptibility to infectious agents, as well as reduced rates of neoplastic transformation. Other potentially useful radioprotectants currently under study include the nutraceutical vitamin E and analogs, a chemically-engineered cytokine, interleukin-1β, and a sustained-release formulation of an aminothiol, amifostine. Results suggest that a new paradigm is evolving for the prophylaxes of radiation injuries, based on use of newly identified, nontoxic, broad-spectrum prophylactic agents whose protective action may be leveraged by subsequent postexposure use of cytokines with organ-specific reparative functions. (author)

  15. New strategies for the prevention of radiation injury. Possible implications for countering radiation hazards of long-term space travel

    Energy Technology Data Exchange (ETDEWEB)

    Seed, T.; Kumar, S.; Whitnall, M. [Armed Forces Radiobiology Research Inst., Bethesda, MD (United States). Radiation Casualty Management] [and others

    2002-12-01

    New strategies for the prevention of radiation injuries are currently being explored with the ultimate aim of developing globally radioprotective, nontoxic pharmacologics. The prophylactic treatments under review encompass such diverse pharmacologic classes as novel immunomodulators, nutritional antioxidants, and cytokines. An immunomodulator that shows promise is 5-androstenediol (AED), a well-tolerated, long-acting and rostene steroid with broad-spectrum radioprotective attributes that include not only protection against acute tissue injury, but also reduced susceptibility to infectious agents, as well as reduced rates of neoplastic transformation. Other potentially useful radioprotectants currently under study include the nutraceutical vitamin E and analogs, a chemically-engineered cytokine, interleukin-1{beta}, and a sustained-release formulation of an aminothiol, amifostine. Results suggest that a new paradigm is evolving for the prophylaxes of radiation injuries, based on use of newly identified, nontoxic, broad-spectrum prophylactic agents whose protective action may be leveraged by subsequent postexposure use of cytokines with organ-specific reparative functions. (author)

  16. Injury to the central nervous system after high LET radiation

    International Nuclear Information System (INIS)

    Laramore, G.E.

    1991-01-01

    To date, clinical experiments with high LET irradiation have used fast neutrons, π-mesons, and heavy ions. The data for all of these modalities will be reviewed here, but by far the greatest body of information is for fast neutrons. Boron neutron capture therapy work for brain tumors, and interesting area in its own right, will not be discussed. In the paper, the author considered separately the brain and the spinal cord in terms of radiation effects. Most of the information on the brain comes from the treatment of high-grade gliomas and so the effects of the tumor and its surrounding edema must be folded in. There is, however, some information relating to the treatment of tumors lying adjacent to the brain. The spinal cord data come primarily from the treatment of head and neck tumors and intrathoracic tumors. Because the majority of these tumors were quite advanced, they often caused the patient's early death, and many patients may not have survived long enough to show the effects of radiation damage even if doses were given that exceeded cord tolerance

  17. Chemoprotection against fractionated radiation exposures with WR-2721: skin injury

    International Nuclear Information System (INIS)

    Echols, F.S.; Yuhas, J.M.

    1976-01-01

    These studies extend the analysis of the potential application of WR-2721 [S-2-(3-aminopropylamino)ethylphosphorothioic acid] to radiation therapy by determining the ability of the drug to protect mice against hair loss induced by multiple exposures to radiation. In the two mouse strains tested, RFM and BALB/c, the relatively low drug dose used (200 mg/kg) protected the mice against hair loss from single exposures by factors of 1.67 and 1.73. The dose necessary to produce a given level of hair loss (ED 50 ) increases with increasing number of fractions. The ED 50 increases as N/sup 0.52/ and N/sup 0.59/ in the two strains of mice when they are not drug-treated, but as N/sup 0.39/ and N/sup 0.50/ in mice that are drug-treated. Thus, the protective effectiveness of WR-2721 decreases with increasing numbers of fractions, but the drug is still able to give a dose-modifying factor of about 1.25 when the total exposure is given as a series of 9 or 10 fractions. WR-2721 appears to offer the possibility of improving the efficiency of radiotherapy under clinical conditions

  18. Apoptosis and mitosis in the small intestine at radiation injury

    International Nuclear Information System (INIS)

    Hashiguchi, Junichiro; Ito, Masahiro; Onizuka, Shinya; Sekine, Ichiro; Uchida, Shinji

    1990-01-01

    A single whole body irradiation was given at a dose rate of 0.298 Gy/min in 6-week-old male mice. Intestinal crypt apoptosis and mitosis cells were determined by delivering radiation doses of 0.4, 0.6, 1.0, 1.5, 2.0, 5.0, 10.0, and 20.0 Gy. The incidence of apoptosis was linearly increased in a dose-dependent manner up to 5.0 Gy, and thereafter, it was gradually decreased. There was a decreased tendency for mitosis with delivering higher radiation doses. The incidence of apoptosis rapidly increased 2 hours after irradiation with either 0.6 Gy or 2.0 Gy, and reached to the peak 4 hours later. It brought about a 18-fold and 28-fold increase for 0.6 Gy and 2.0 Gy, respectively, relative to that before irradiation. Mitosis cells decreased by half one hour after irradiation with 0.6 Gy, and then returned to the pre-irradiation value through synchronization 24 hours later. The number of cells positive to BrdU was 776 in the group of mice without irradiation and 479 in the group of mice irradiated with 2.0 Gy. (N.K.)

  19. Radiation-induced skin injury in the animal model of scleroderma: implications for post-radiotherapy fibrosis

    International Nuclear Information System (INIS)

    Kumar, Sanath; Kolozsvary, Andrew; Kohl, Robert; Lu, Mei; Brown, Stephen; Kim, Jae Ho

    2008-01-01

    Radiation therapy is generally contraindicated for cancer patients with collagen vascular diseases (CVD) such as scleroderma due to an increased risk of fibrosis. The tight skin (TSK) mouse has skin which, in some respects, mimics that of patients with scleroderma. The skin radiation response of TSK mice has not been previously reported. If TSK mice are shown to have radiation sensitive skin, they may prove to be a useful model to examine the mechanisms underlying skin radiation injury, protection, mitigation and treatment. The hind limbs of TSK and parental control C57BL/6 mice received a radiation exposure sufficient to cause approximately the same level of acute injury. Endpoints included skin damage scored using a non-linear, semi-quantitative scale and tissue fibrosis assessed by measuring passive leg extension. In addition, TGF-β1 cytokine levels were measured monthly in skin tissue. Contrary to our expectations, TSK mice were more resistant (i.e. 20%) to radiation than parental control mice. Although acute skin reactions were similar in both mouse strains, radiation injury in TSK mice continued to decrease with time such that several months after radiation there was significantly less skin damage and leg contraction compared to C57BL/6 mice (p < 0.05). Consistent with the expected association of transforming growth factor beta-1 (TGF-β1) with late tissue injury, levels of the cytokine were significantly higher in the skin of the C57BL/6 mouse compared to TSK mouse at all time points (p < 0.05). TSK mice are not recommended as a model of scleroderma involving radiation injury. The genetic and molecular basis for reduced radiation injury observed in TSK mice warrants further investigation particularly to identify mechanisms capable of reducing tissue fibrosis after radiation injury

  20. Diagnosis, injury and prevention of internal radiation exposure

    International Nuclear Information System (INIS)

    Tatsuzaki, Hideo

    2012-01-01

    Radiation exposure is classified into three categories: external exposure, surface contamination, and internal exposure (also called internal contamination). Internal exposure is an exposure by the ionizing radiation emitted from radioactive materials taken into a human body. Uptake of radioactive materials can go through inhalation, ingestion, or wound contamination. Not like external exposure, alpha ray or beta ray, which has a limited penetration, is also important in internal exposure. Diagnosis of internal exposure is based on measurement and dose assessment in addition to the history taking. Two methods, direct measurement and/or bioassay (indirect measurement), are used for the measurement. These measurements provide information of radioactive materials in the body at the time of the measurement. The exposure dose to the body needs to be calculated in a process of dose assessment, based on the results of these measurements and history of intake, either acute intake or chronic intake. Another method, measurement of environmental samples or food stuff, is also used for dose assessment. For internal exposure, radiation dose to the body is expressed as committed effective dose or committed equivalent dose, which are accumulation of dose over a defined period. Radioactive materials taken into body are transferred among many body components depending on the type of radionuclide or chemicals etc. Some radioactive materials concentrate in a specific organ. Symptoms and signs depend on the distribution of the radioactive materials in the body. Monitoring the concentration in air or foods is conducted in order to control human activities and foods and consequently reduce the amount of intake to human bodies as a preventive measure. Prevention of internal exposure is also conducted by protective gears such as full face masks. Iodine prophylaxis could be used against radioactive iodine intake. Stable iodine, mostly potassium iodide, could be taken into the thyroid and

  1. Surgical treatment of radiation injuries of the colon and rectum

    International Nuclear Information System (INIS)

    Jao, S.W.; Beart, R.W. Jr.; Gunderson, L.L.

    1986-01-01

    Between 1950 and 1983, radiation-induced proctitis was diagnosed proctoscopically in 720 patients at the Mayo Clinic. Sixty-two patients with severe colorectal symptoms were treated surgically. The interval from cessation of radiotherapy to onset of symptoms ranged from 3 weeks to 24 months (mean 33 months). The 62 patients underwent a total of 143 operations with 8 operative deaths (13 percent), and 40 patients (65 percent) had 61 complications. The morbidity rate was lower after colostomy alone (44 percent in 27 patients) than after more aggressive operations (80 percent in 35 patients). Transverse loop colostomy and descending colostomy were safer than sigmoid colostomy. The dissection adhesions, opening of tissue planes, and careless manipulation of intestine may result in necrosis and perforation of the intestine, bladder, or vaginal wall; these were the main causes of fecal and other internal fistulas in our study

  2. The forecasting of radiation injuries of the urinary bladder and rectum in patients with uterine cervix carcinoma

    International Nuclear Information System (INIS)

    Zharinov, G.M.; Gabelov, A.A.

    1984-01-01

    The frequency and degree of severity of radiation in unjuries of the urinary bladder and rectum after combined treatment of 725 patients with uterine cercix carcigoma are analysed. A quantitative index was worked out permi-- tting one to give an ob ective evaluation of the degree of early radiation reactions of the ad acent organs. The determination of the ''radiation injuries prognosis index'' (RIPI) makes it possible to forecast the occurence and degree of severity of late radiation injuries of the urinary bladder and rectum. The evaluation of RIPI mean values in the patients' groups provides an opportunity to oompare the damaging effect of different methods and regiment directly in the process of radiation therapy. The above method improves the potentialities of the forecasting of radiation injuries of the urinary bladder and rectum in patients with uterine cervix carcinoma

  3. “Clavicular Duplication Causing Thoracic Outlet Obstruction ...

    African Journals Online (AJOL)

    and left shoulder pain radiating to hand, and associated with paresthesia and .... results in fracture instead of acromioclavicular joint sprain and a “new” clavicle ... such as anomalous cervical ribs, hypoplastic first thoracic rib, exostoses of the ...

  4. Thoracic and abdominopelvic actinomycosis

    African Journals Online (AJOL)

    thoracic disease.1,2,4 The chronic progressive suppurative infection ... venous Penicillin G for 4 - 6 weeks being the treatment of ... pathology was demonstrated in the liver. (Figs 7a and b ). .... ulceration (may resemble Crohn's disease).3. 2.

  5. Society of Thoracic Surgeons

    Science.gov (United States)

    ... Apply for Membership Membership Directory Pay Your Dues Industry Mailing List License & eBlast Communications Programs Advertise on ... Hotel Discount Copyright © 2017 The Society of Thoracic Surgeons. ...

  6. Medical management of severe local radiation injury after acute X-ray exposure

    International Nuclear Information System (INIS)

    Bushmanov, A.; Nadezhina, N.; Kretov, A.

    2008-01-01

    Medical management during acute period in a case of severe local radiation injury after acute X-ray exposure includes 3 stages. During the fist stage patient got conservative treatment according to the common pathogenetic mechanisms of LRI (dis aggregating therapy, stimulation of regeneration, dis intoxication therapy, antibiotic therapy, pain relief therapy, Local anti-burn therapy-specific non-adhesive bandage with antiseptic and anti-burn medicaments); estimation of severity, deepness and area of injury by clinical picture and dates of instrumental methods of examining; defining necessity and volume of surgical treatment; preparing arrangements for surgical treatment. This stage ends with forming of demarcation line of a very hard severity of a Local Radiation Injure. The second stage includes necrectomy of the area of a very hard severity with microsurgical plastic by re vascularized flap and auto dermoplastic. The third stage - adaptation of re vascularized flap and total epithelization of injured area. (author)

  7. Change in catalase and peroxidase activity in rat blood in case of combined radiation and mechanical injuries

    International Nuclear Information System (INIS)

    Volkovaya, T.A.

    1982-01-01

    Changes of catalase and peroxide activity of blood in rats in case of irradiation at 2.0 and 7.0 Gy, mechanical injury of animal chest and combined radiation injury were studied. The given data testify to considerable increase of the above enzymes activity in case of all these effects. The less decrease of catalase and peroxide activity was observed after infliction of mechanical injury alone. Aggravating effect of mechanical injury on the irradiated organism leads to more noticeable decrease of catalase activity (at early periods of observation) in comparison with radiation effect. Peroxide changes in case of combined radiation and mechanical injury of rats differ slightly from similar factors observed in case of irradiation alone

  8. Treatment of chronic radiation injury over the shoulder with a latissimus dorsi myocutaneous flap

    International Nuclear Information System (INIS)

    Mendelson, B.C.; Masson, J.K.

    1977-01-01

    We report our experiences in treating chronic radiation injury about the shoulder, a complication of radiation after mastectomy. Left untreated, these can result in chronic infection and/or amputation. The coverage of a large shoulder area presents certain unique problems, which severely limit the usefulness of traditional procedures. We have found that the remarkable size and versatility of the latissimus dorsi myocutaneous flap enables one to use it with relative simplicity and safety. A further great advantage is that it brings new permanent blood supply into this ischemic area, thus favoring rapid healing and durable coverage

  9. Protective effects of seabuckthorn pulp and seed oils against radiation-induced acute intestinal injury

    International Nuclear Information System (INIS)

    Shi, Jing; Wang, Lan; Lu, Yan; Ji, Yue; Wang, Yaqing; Dong, Ke; Kong, Xiangqing; Sun, Wei

    2017-01-01

    Radiation-induced gastrointestinal syndrome, including nausea, diarrhea and dehydration, contributes to morbidity and mortality after medical or industrial radiation exposure. No safe and effective radiation countermeasure has been approved for clinical therapy. In this study, we aimed to investigate the potential protective effects of seabuckthorn pulp and seed oils against radiation-induced acute intestinal injury. C57/BL6 mice were orally administered seabuckthorn pulp oil, seed oil and control olive oil once per day for 7 days before exposure to total-body X-ray irradiation of 7.5 Gy. Terminal deoxynucleotidyl transferase dUTP nick end labeling, quantitative real-time polymerase chain reaction and western blotting were used for the measurement of apoptotic cells and proteins, inflammation factors and mitogen-activated protein (MAP) kinases. Seabuckthorn oil pretreatment increased the post-radiation survival rate and reduced the damage area of the small intestine villi. Both the pulp and seed oil treatment significantly decreased the apoptotic cell numbers and cleaved caspase 3 expression. Seabuckthorn oil downregulated the mRNA level of inflammatory factors, including tumor necrosis factor-α, interleukin (IL)-1β, IL-6 and IL-8. Both the pulp and seed oils elevated the level of phosphorylated extracellular-signal-regulated kinase and reduced the levels of phosphorylated c-Jun N-terminal kinase and p38. Palmitoleic acid (PLA) and alpha linolenic acid (ALA) are the predominant components of pulp oil and seed oil, respectively. Pretreatment with PLA and ALA increased the post-radiation survival time. In conclusion, seabuckthorn pulp and seed oils protect against mouse intestinal injury from high-dose radiation by reducing cell apoptosis and inflammation. ALA and PLA are promising natural radiation countermeasure candidates.

  10. Contribution to the pathogenesis of radiation-induced injury to large arteries

    International Nuclear Information System (INIS)

    Zidar, Nina; Ferluga, Dusan; Hvala, Asta; Popovic, Mara; Soba, Erika

    1997-01-01

    We report a case of a 35-year-old man who died of a brain infarct 20 months after radiotherapy for carcinoma of the tonsil with metastases to the cervical lymph nodes. Histology revealed mild atherosclerosis, necrotizing vasculitis, and occlusive thrombosis of the internal carotid artery. Significant changes were observed in the vasa vasorum; swelling and detachment of the endothelium, subendothelial oedema, hyaline change, fibrinoid necrosis of the vessel walls with mononuclear cellular infiltration, accompanied by focal haemorrhages and chronic inflammation in the periadventitial soft tissue. We believe that these changes of the vasa vasorum and necrotizing vasculitis are causally related and that vasculitis represents focal ischaemic necroses with inflammatory reaction. Our findings support the hypothesis, based on experimental studies, that injury to the vasa vasorum is an important mechanism in the development of radiation-induced vasculopathy of large arteries. They also suggest an evolution of the injury to the vasa vasorum and periadventitial tissue from the early lesions described in our patient, to late stages resulting in dense periadventitial fibrosis as reported previously. We suggest that injury to the vasa vasorum and the consequent ischaemic lesions of the arterial wall are morphological features distinguishing radiation-induced arterial injury from spontaneous atherosclerosis. (author)

  11. STUDIES IN WORKMEN'S COMPENSATION AND RADIATION INJURY. VOLUME III, A REPORT ON IONIZING RADIATION RECORD KEEPING.

    Science.gov (United States)

    Atomic Energy Commission, Washington, DC.

    THE SUCCESSFUL OPERATION OF THE PERMISSIBLE LEVEL CONCEPT OF RADIATION CONTROL NECESSARILY ENTAILS A COMPREHENSIVE SYSTEM UNDER WHICH EXPOSURE MUST BE RECORDED AND EMPLOYEES NOTIFIED OF THEIR EXPOSURE HISTORY. IN AN INVESTIGATION OF RECORD KEEPING NECESSARY TO PROCESS RADIATION CLAIMS, QUESTIONNAIRES OR LETTERS WERE RECEIVED FROM 45 STATE AGENCIES…

  12. Application of Multivariate Modeling for Radiation Injury Assessment: A Proof of Concept

    Directory of Open Access Journals (Sweden)

    David L. Bolduc

    2014-01-01

    Full Text Available Multivariate radiation injury estimation algorithms were formulated for estimating severe hematopoietic acute radiation syndrome (H-ARS injury (i.e., response category three or RC3 in a rhesus monkey total-body irradiation (TBI model. Classical CBC and serum chemistry blood parameters were examined prior to irradiation (d 0 and on d 7, 10, 14, 21, and 25 after irradiation involving 24 nonhuman primates (NHP (Macaca mulatta given 6.5-Gy 60Co Υ-rays (0.4 Gy min−1 TBI. A correlation matrix was formulated with the RC3 severity level designated as the “dependent variable” and independent variables down selected based on their radioresponsiveness and relatively low multicollinearity using stepwise-linear regression analyses. Final candidate independent variables included CBC counts (absolute number of neutrophils, lymphocytes, and platelets in formulating the “CBC” RC3 estimation algorithm. Additionally, the formulation of a diagnostic CBC and serum chemistry “CBC-SCHEM” RC3 algorithm expanded upon the CBC algorithm model with the addition of hematocrit and the serum enzyme levels of aspartate aminotransferase, creatine kinase, and lactate dehydrogenase. Both algorithms estimated RC3 with over 90% predictive power. Only the CBC-SCHEM RC3 algorithm, however, met the critical three assumptions of linear least squares demonstrating slightly greater precision for radiation injury estimation, but with significantly decreased prediction error indicating increased statistical robustness.

  13. Radiation injuries of the gastrointestinal tract in Hodgkin's disease: the role of exploratory laparotomy and fractionation

    International Nuclear Information System (INIS)

    Gallez-Marchal, D.; Fayolle, M.; Henry-Amar, M.; Le Bourgeois, J.P.; Rougier, P.; Cosset, J.M.

    1984-01-01

    Out of 134 patients irradiated below the diaphragm to a dose of 40 Gy for Hodgkin's disease at the Institut Gustave-Roussy, 19 (14%) were subsequently found to present with radiation injuries of the gastrointestinal tract. Since five patients presented with two different injuries, 24 radiolesions were observed. Most of them (17 out of 24) were gastric or duodenal. Twelve (out of 24) were ulcers. Nine patients required surgery. A complete cure of the radiation injuries was obtained in 15 out of 19 patients. Sex, age, stage, histology or initial chemotherapy were not found to play a role in the occurrence of radiation damage. On the contrary, the role of a previous exploratory laparotomy appeared important; for the patients who underwent laparotomy and irradiation, the complication rate was 23%. For the patients treated by irradiation alone, the complication rate was 7% (p < 0.01). Fractionation was found to be another important parameter: for 52 patients treated using 3 weekly fractions of 3.3 Gy, the complication rate was 25% compared to 8% (p < 0.01) for 76 patients treated using 4 weekly fractions of 2.5 Gy. Combining these two factors, the authors found a 42% complication rate for the group of patients who underwent laparotomy and who were treated by means of 3 fractions of 3.3 Gy per week, whereas patients irradiated using 4 weekly fractions of 2.5 Gy, without any previous laparotomy, has only a 5% complication risk (p < 0.001). (Auth.)

  14. The primary study on protective effects of vallinin derivative on cell injury induced by radiation

    International Nuclear Information System (INIS)

    Zheng Hong; Wang Siying; Yan Yuqian; Wang Lin; Xu Qinzhi; Cong Jianbo; Zhou Pingkun

    2008-01-01

    In this paper, the protective effects of vallinin derivative VND3207 on cell injury induced by radiation were studied by the methods of methyl thiazolyl tetrazolium colorimetric assay (MTT) and electron spin resonance (ESR). At first, MTF method was used to evaluate the cytotoxicity of vallinin derivatives (VND3202-VND3209) in HFS cells. Then, MTT method was used to measure the proliferation activity of HeLa cells with 2 Gy irradiation treated with vallinin derivatives and measure the proliferation of AHH-1 cells treated with VND3207 before exposed to 4 Gy irradiation. And ESR detected the antioxidation activity of vallinin and VND3207. The results showed that VND3207 and VND3206 presented no toxin within 50 panol/L, and VND3207 and VND3209 had no proliferous effects on HeLa cells while VND3206 could expedite the tumor cell proliferation at 30 μmol/L, and by comrades VND3208 showed increased radiosensitivity of the HeLa cells. For the AHH1 cells exposed to 4 Gy irradiation, VND3207 presented the protective effects against radiation injury. ESR results also suggested that VND3207 could clean out free radicals. Its effect was far more potent than that of vanillin. From this study we primarily screened out the vallinin derivative VND3207 which has protective effects on cell injury induced by radiation and provided data for future research work. (authors)

  15. Achieving a neutral cervical spine position in suspected spinal cord injury in children: analysing the use of a thoracic elevation device for imaging the cervical spine in paediatric patients.

    Science.gov (United States)

    Pandie, Zaahid; Shepherd, Mike; Lamont, Tony; Walsh, Mark; Phillips, Mark; Page, Colin

    2010-08-01

    Paediatric patients with suspected cervical spine injury (CSI) are routinely immobilised on a firm surface using a hard collar, which results in excessive flexion of the cervical spine due to the relatively large size of the occiput. The objective of this study was to determine whether the use of a thoracic elevation device (TED) results in a more neutral cervical spine position and reduces the occurrence of cervical spine hyperflexion. A prospective cohort study was conducted at two Emergency Departments (sites A and B) from January 2006 to May 2007. Children TED and those at site B did not. x-Rays from both sites were analysed for flexion, extension or neutrality of the cervical spine as defined by the Cobb angle. A total of 76 patients were identified at site A and site B. There were four exclusions at each site for poor quality images. 51 patients in the site A group were found to be in neutral position (71%), compared to 29 patients in the site B group (43%) (p=0.001). One patient (1%) who had a TED was found to be hyperflexed (>10 degrees), whereas 12 (18%) patients at site B were hyperflexed (p=0.001). The use of a TED appears to produce a greater proportion of neutral cervical spine films in children < or =10 years of age presenting for suspected CSI.

  16. Thioredoxin mitigates radiation-induced hematopoietic stem cell injury in mice

    Directory of Open Access Journals (Sweden)

    Pasupathi Sundaramoorthy

    2017-11-01

    Full Text Available Abstract Background Radiation exposure poses a significant threat to public health. Hematopoietic injury is one of the major manifestations of acute radiation sickness. Protection and/or mitigation of hematopoietic stem cells (HSCs from radiation injury is an important goal in the development of medical countermeasure agents (MCM. We recently identified thioredoxin (TXN as a novel molecule that has marked protective and proliferative effects on HSCs. In the current study, we investigated the effectiveness of TXN in rescuing mice from a lethal dose of total body radiation (TBI and in enhancing hematopoietic reconstitution following a lethal dose of irradiation. Methods We used in-vivo and in-vitro methods to understand the biological and molecular mechanisms of TXN on radiation mitigation. BABL/c mice were used for the survival study and a flow cytometer was used to quantify the HSC population and cell senescence. A hematology analyzer was used for the peripheral blood cell count, including white blood cells (WBCs, red blood cells (RBCs, hemoglobin, and platelets. Colony forming unit (CFU assay was used to study the colongenic function of HSCs. Hematoxylin and eosin staining was used to determine the bone marrow cellularity. Senescence-associated β-galactosidase assay was used for cell senescence. Western blot analysis was used to evaluate the DNA damage and senescence protein expression. Immunofluorescence staining was used to measure the expression of γ-H2AX foci for DNA damage. Results We found that administration of TXN 24 h following irradiation significantly mitigates BALB/c mice from TBI-induced death: 70% of TXN-treated mice survived, whereas only 25% of saline-treated mice survived. TXN administration led to enhanced recovery of peripheral blood cell counts, bone marrow cellularity, and HSC population as measured by c-Kit+Sca-1+Lin– (KSL cells, SLAM + KSL cells and CFUs. TXN treatment reduced cell senescence and radiation

  17. Biochemical Indicators of Radiation Injury in Man. Proceedings of a Scientific Meeting

    International Nuclear Information System (INIS)

    1971-01-01

    After an organism has suffered a radiation insult, knowledge of the dose and localization of the exposure is of the greatest importance for the treatment of any radiation damage. Supplementary to the information obtained from physical dosimetry, data obtained by biochemical indicators can, on the basis of metabolic changes in the irradiated organism, help in making early diagnosis, in assessing the extent of the radiation injury, and making a prognosis. Biochemical tests under optimal conditions would not depend on the quality and distribution of the dose in the body and would also reflect the sensitivity of the individual organisms. The International Atomic Energy Agency and the World Health Organization convened a joint scientific meeting on Biochemical Indicators of Radiation Injury in Man in Paris-Le Vésinet, France, from 22 to 26 June 1970. The main purpose of the meeting was to discuss recent problems in determining which biochemical and metabolic changes occurring in irradiated organisms could be used as indicators of radiation injury and its extent, and could thus be of help in planning the proper treatment of the injured persons. During the meeting the results obtained with various biochemical indicators, and experimental techniques and laboratory methods used in this field, were evaluated and compared. Both research workers and clinicians were invited to participate at the meeting. They discussed the possible value of several tests, used successfully in experimental animals, for clinical application; ways of standardizing suitable tests; and mutual collaboration between laboratories and clinics. The outcome of their discussions is summarized in the conclusions and recommendations which are included in these Proceedings together with the papers presented

  18. Notification determining technical standards concerning prevention of radiation injuries by electron capture detectors for gas chromatography

    International Nuclear Information System (INIS)

    1981-01-01

    This rule is established under the provisions of the law on the prevention of radiation injuries by radioisotopes, the ordinance and the regulation for the execution of the law. This rule is applied to electron capture detectors for gas chromatography under the law. Basic terms are defined, such as detector radiation source, detector container and carrier gas. The detectors shall consist of detector radiation sources and containers, and the containers must be such that the radiation sources can not be easily taken away and never cause the danger to fall off. The induction and discharge mouths of the detector containers shall be shut tightly with caps, etc. The main structures and radiation sources of detectors shall be made of materials, which are difficult to corrode, and do not melt and easily cause chemical change below 800 deg. C. Detector radiation sources shall be made of metals plated with nickel 63 less than 20 milli-curie. The radiation dose rate on the surface of a detector shall be shielded to less than 0.06 milli-rem an hour. The temperature of detectors and carrier gas shall not exceed 350 deg. C. Corrosive gas shall not be used as carrier gas. The period of effective indication is 5 years. The method of washing, and the conditions of leak, heat-resistance and shock-resistance examinations are defined, respectively. (Okada, K.)

  19. Right main bronchial fracture resolution by digital thoracic drainage system.

    Science.gov (United States)

    Cortés Julián, Gildardo; Mier, José M; Iñiguez, Marco A; Guzmán de Alba, Enrique

    2016-03-01

    Tracheobronchial stenosis is common in the thoracic surgery service, and iatrogenic injury of the airway after manipulation is not infrequent. When a digital thoracic drainage system came onto the market, many advantages were evident. A 24-year-old woman with critical right main bronchial stenosis underwent airway dilation that was complicated by a tear with a massive air leak, resulting in a total right pneumothorax. We employed a pleural drain connected to a digital thoracic drainage system. The drain was removed 2 days after successful resolution of the air leak. © The Author(s) 2015.

  20. The influence of infrared radiation on short-term ultraviolet-radiation-induced injuries

    International Nuclear Information System (INIS)

    Kaidbey, K.H.; Witkowski, T.A.; Kligman, A.M.

    1982-01-01

    Because heat has been reported to influence adversely short- and long-term ultraviolet (UV)-radiation-induced skin damage in animals, we investigated the short-term effects of infrared radiation on sunburn and on phototoxic reactions to topical methoxsalen and anthracene in human volunteers. Prior heating of the skin caused suppression of the phototoxic response to methoxsalen as evidenced by an increase in the threshold erythema dose. Heat administered either before or after exposure to UV radiation had no detectable influence on sunburn erythema or on phototoxic reactions provoked by anthracene

  1. Biochemical and Radiobiological Factors in the Early Detection of Radiation Injury in Mammals

    Energy Technology Data Exchange (ETDEWEB)

    Cole, L. J. [Life Sciences Division, Stanford Research Institute, Menlo Park, CA (United States)

    1971-03-15

    In considering the body of radiobiological knowledge upon which the present possibilities for the development of an objective quantitative laboratory procedure for early detection of radiation injury depend, it is evident that there are at least three general categories of radiation effects which are relevant to this objective: (1) Products of the enzymatic-chemical breakdown of macromolecules, and lysis of killed or dying cells from radiosensitive tissues, for example deoxypolynucleotides from lymphoid tissues and bone marrow; (2) Radiation-induced inhibition of synthesis of deoxyribonucleic acid (DNA) and/or other macromolecules, eliciting alterations in tissue and blood concentrations and pool size of metabolic intermediates in the synthesis, for example, deoxycytidine; (3) Radiation-induced alterations, suppression, or cessation of specialized cell function; of particular interest here is the immunological functions of lymphocytes, including those in the circulating blood. For rodents, the exquisite radiosensitivity of bone-marrow-stem cells as well as of lymphocytes has been precisely measured by modern cellular radiobiological techniques: the colony-forming technique of Till and McCulloch, yielding a D{sub 0} for bone-marrow cells of about 80 R; and the graft-versus-host reactivity of transplanted lymphocytes yielding a similar D{sub 0} value. In our own hands, a modified colony-formation technique for dog bone-marrow cells irradiated in.vitro and in vivo give D{sub 0} values of {approx}100 R. Thus, on the basis of radiation sensitivity and the time-relationships for interphase cell death for lymphocytes, it appears that this cell class is probably the best ''candidate'' source for an early radiation-injury detection system. However,- the important report by Zicha and Buric indicates that extrapolation of biochemical data on radiation dosimetry from rodents to man is not necessarily feasible, at least in the. case of the urinary excretion of deoxycytidine

  2. Digital radiography of crush thoracic trauma in the Sichuan earthquake

    Science.gov (United States)

    Dong, Zhi-Hui; Shao, Heng; Chen, Tian-Wu; Chu, Zhi-Gang; Deng, Wen; Tang, Si-Shi; Chen, Jing; Yang, Zhi-Gang

    2011-01-01

    AIM: To investigate the features of crush thoracic trauma in Sichuan earthquake victims using chest digital radiography (CDR). METHODS: We retrospectively reviewed 772 CDR of 417 females and 355 males who had suffered crush thoracic trauma in the Sichuan earthquake. Patient age ranged from 0.5 to 103 years. CDR was performed between May 12, 2008 and June 7, 2008. We looked for injury to the thoracic cage, pulmonary parenchyma and the pleura. RESULTS: Antero-posterior (AP) and lateral CDR were obtained in 349 patients, the remaining 423 patients underwent only AP CDR. Thoracic cage fractures, pulmonary contusion and pleural injuries were noted in 331 (42.9%; 95% CI: 39.4%-46.4%), 67 and 135 patients, respectively. Of the 256 patients with rib fractures, the mean number of fractured ribs per patient was 3. Rib fractures were mostly distributed from the 3rd through to the 8th ribs and the vast majority involved posterior and lateral locations along the rib. Rib fractures had a significant positive association with non-rib thoracic fractures, pulmonary contusion and pleural injuries (P < 0.001). The number of rib fractures and pulmonary contusions were significant factors associated with patient death. CONCLUSION: Earthquake-related crush thoracic trauma has the potential for multiple fractures. The high number of fractured ribs and pulmonary contusions were significant factors which needed appropriate medical treatment. PMID:22132298

  3. Non-invasive assessment of radiation injury with electrical impedance spectroscopy

    International Nuclear Information System (INIS)

    Osterman, K Sunshine; Hoopes, P Jack; De Lorenzo, Christine; Gladstone, David J; Paulsen, Keith D

    2004-01-01

    A detailed understanding of non-targeted normal tissue response is necessary for the optimization of radiation treatment plans in cancer therapy. In this study, we evaluate the ability of electrical impedance spectroscopy (EIS) to non-invasively determine and quantify the injury response in soft tissue after high dose rate (HDR) irradiation, which is characterized by large localized dose distributions possessing steep spatial gradients. The HDR after-loading technique was employed to irradiate small volumes of muscle tissue with single doses (26-52 Gy targeted 5 mm away from the source). Impedance measurements were performed on 29 rats at 1, 2 and 3 month post-irradiation, employing 31 frequencies in the 1 kHz to 1 MHz range. Over the first 3 months, conductivity increased by 48% and 26% following target doses of 52 Gy and 26 Gy 5 mm from the HDR source, respectively. Injury, assessed independently through a grid-based scoring method showed a quadratic dependence on distance from source. A significant injury (50% of cells atrophied, necrotic or degenerating) in 1.2% of the volume, accompanied by more diffuse injury (25% of cells atrophied, necrotic or degenerating) in 9% of the tissue produced a conductivity increase of 0.02 S m -1 (8% over a baseline of 0.24 S m -1 ). This was not statistically significant at p 0.01. Among treatment groups, injury differences in 22% of the volume led to statistically significant differences in conductivity of 0.07 S m -1 (23% difference in conductivity). Despite limitations, the success of EIS in detecting responses in a fraction of the tissue probed, during these early post-irradiation time-points, is encouraging. Electrical impedance spectroscopy may provide a useful metric of atrophy and the development of fibrosis secondary to radiation that could be further developed into a low-cost imaging method for radiotherapy monitoring and assessment

  4. Effects of Berberine Against Radiation-Induced Intestinal Injury in Mice

    International Nuclear Information System (INIS)

    Li Guanghui; Zhang Yaping; Tang Jinliang; Chen Zhengtang; Hu Yide; Wei Hong; Li Dezhi; Hao Ping; Wang Donglin

    2010-01-01

    Purpose: Radiation-induced intestinal injury is a significant clinical problem in patients undergoing abdominal radiotherapy (RT). Berberine has been used as an antimicrobial, anti-inflammatory, and antimotility agent. The present study investigated the protective effect of berberine against radiation-induced intestinal injury. Methods and Materials: The mice were administrated berberine or distilled water. A total of 144 mice underwent 0, 3, 6, 12, or 16 Gy single session whole-abdominal RT and 16 mice underwent 3 Gy/fraction/d for four fractions of fractionated abdominal RT. Tumor necrosis factor-α, interleukin-10, diamine oxidase, intestinal fatty acid-binding protein, malonaldehyde, and apoptosis were assayed in the mice after RT. The body weight and food intake of the mice receiving fractionated RT were recorded. Another 72 mice who had undergone 12, 16, or 20 Gy abdominal RT were monitored for mortality every 12 h. Results: The body weight and food intake of the mice administered with distilled water decreased significantly compared with before RT. After the same dose of abdominal RT, tumor necrosis factor-α, diamine oxidase, intestinal fatty acid-binding protein in plasma and malonalhehyde and apoptosis of the intestine were significantly greater in the control group than in the mice administered berberine (p < .05-.01). In contrast, interleukin-10 in the mice with berberine treatment was significantly greater than in the control group (p < .01). A similar result was found in the fractionated RT experiment and at different points after 16 Gy abdominal RT (p < .05-.01). Berberine treatment significantly delayed the point of death after 20 Gy, but not 16 Gy, abdominal RT (p < .01). Conclusion: Treatment with berberine can delay mortality and attenuated intestinal injury in mice undergoing whole abdominal RT. These findings could provide a useful therapeutic strategy for radiation-induced intestinal injury.

  5. A study of radiation-induced cerebral vascular injury in nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis.

    Directory of Open Access Journals (Sweden)

    Jianhong Ye

    Full Text Available To investigate radiation-induced carotid and cerebral vascular injury and its relationship with radiation-induced temporal lobe necrosis in nasopharyngeal carcinoma (NPC patients.Fifty eight NPC patients with radiation-induced temporal lobe necrosis (TLN were recruited in the study. Duplex ultrasonography was used to scan bilateral carotid arterials to evaluate the intima-media thickness (IMT and occurrence of plaque formation. Flow velocities of bilateral middle cerebral arteries (MCAs, internal carotid arteries (ICAs and basal artery (BA were estimated through Transcranial Color Doppler (TCD. The results were compared with data from 33 patients who were free from radiation-induced temporal lobe necrosis after radiotherapy and 29 healthy individuals.Significant differences in IMT, occurrence of plaques of ICAs and flow velocities of both MCAs and ICAs were found between patients after radiotherapy and healthy individuals (p<0.05. IMT had positive correlation with post radiation interval (p = 0.049. Compared with results from patients without radiation-induced TLN, the mean IMT was significantly thicker in patients with TLN (p<0.001. Plaques were more common in patients with TLN than patients without TLN (p = 0.038. In addition, flow velocities of MCAs and ICAs in patients with TLN were much faster (p<0.001, p<0.001. Among patients with unilateral TLN, flow velocity of MCAs was significantly different between ipsilateral and contralateral sides to the lesion (p = 0.001.Thickening of IMT, occurrence of plaque formation and hemodynamic abnormality are more common in patients after radiotherapy, especially in those with TLN, compared with healthy individuals.

  6. An experimental study on acute brain radiation injury: Dynamic changes in proton magnetic resonance spectroscopy and the correlation with histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Li, Hui, E-mail: lihui@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Li, Jian-peng, E-mail: lijp@sysucc.org.cn [Department of Radiology, Dongguan People' s Hospital, Dongguan City (China); Lin, Cheng-guang, E-mail: linchg@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou (China); Liu, Xue-wen, E-mail: liuxw@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Geng, Zhi-jun, E-mail: gengzhj@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Mo, Yun-xian, E-mail: moyx@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Zhang, Rong, E-mail: zhangr@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Xie, Chuan-miao, E-mail: xchuanm@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China)

    2012-11-15

    Purpose: To investigate the correlation between the alterations of single-voxel {sup 1}H MRS and the histopathological characteristics of radiation brain injury following radiation. Materials and methods: Twenty-seven rabbits were randomized into nine groups to receive radiation with a single dose of 25 Gy. The observation time points included a pre-radiation and 1, 2, 3, 4, 5, 6, 7, and 8 wk following radiation. Each treatment group underwent conventional MRI and single-voxel {sup 1}H MRS, N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were observed over the region of interest, and the presence or absence of lactate (Lac) and lipid (Lip) was detected. Histological specimens of each group were obtained after image acquisition. Results: The values of Cho were significantly increased in the first 3 wk, and decreased over the following 5 wk after radiation. Levels of NAA showed a trend toward a decrease 5 wk after radiation. The levels of Cr were not changed between before and after radiation. The Cho/NAA metabolic ratio was significantly increased in weeks 6, 7, and 8 following irradiation, compared to pre-radiation values. Vascular and glial injury appeared on 2 wk after RT in the histology samples, until 4 wk after RT, necrosis of the oligodendrocytes, neuronal degeneration and demyelination could be observed. Conclusions: MRS is sensitive to detect metabolic changes following radiation, and can be used in the early diagnosis of radiation brain injury.

  7. Abdominoendorectal resection with peranal anastomosis in the treatment of radiation injuries of the rectum

    Energy Technology Data Exchange (ETDEWEB)

    Athanasiadis, S.; Girona, J.

    1982-01-01

    During the period 1974-1980 39 patients underwent operations at the Prosper Hospital in Recklinghausen for radiation injuries to the rectum or rectosigmoid. They comprised 22 patients with rectovaginal fistulas, 6 with ulcers, 3 suffering from severe hemorrhagic proctitis, 5 with rectal strictures, 1 with necrosis, and 2 with radiation ulcers and carcinoma. A sphincter-saving operative method of treating postirradiation damage of the rectum is presented. The technique involves the peranal anastomosis of healthy colon to the midanal canal using a sleeve anastomosis. Technical and functional results of resectional surgery for the rectal complications of radiation therapy are reported. Subjectively, total continence was present in 78%, only 1 patient was incontinent because of flatus and watery stools.

  8. The abdominoendorectal resection with peranal anastomosis in the treatment of radiation injuries of the rectum

    International Nuclear Information System (INIS)

    Athanasiadis, S.; Girona, J.

    1982-01-01

    During the period 1974-1980 39 patients underwent operations at the Prosper Hospital in Recklinghausen for radiation injuries to the rectum or rectosigmoid. They comprised 22 patients with rectovaginal fistulas, 6 with ulcers, 3 suffering from severe hemorrhagic proctitis, 5 with rectal strictures, 1 with necrosis, and 2 with radiation ulcers and carcinoma. A sphincter-saving operative method of treating postirradiation damage of the rectum is presented. The technique involves the peranal anastomosis of healthy colon to the midanal canal using a sleeve anastomosis. Technical and functional results of resectional surgery for the rectal complications of radiation therapy are reported. Subjectively, total continence was present in 78%, only 1 patient was incontinent because of flatus and watery stools. (orig.) [de

  9. Radiation sensitivity and the acute and chronical radiation injury of the liver. Strahlenempfindlichkeit und die akute und chronische Strahlenschaedigung der Leber

    Energy Technology Data Exchange (ETDEWEB)

    Lesch, R [Freiburg Univ. (Germany, F.R.). Abt. Experimentelle Pathologie

    1976-01-01

    The extended German version of the contribution 'Radiation-induced injury of the liver' from the manual of experimental pharmacology, volume XVI, part 5 (p. 227-304), Springer Verlag, Berlin-Heidelberg-New York 1976, is dealt with here. Following a brief presentation of the radiation-induced change of the human liver by external and internal radiation source, experimental results in the latter case of the radiation effect on the regeneration behaviour of the liver particularly regarding the nucleic acid synthesis are indicated especially using findings after thorotrast application. Furthermore, effects on the metabolic activities and on the liver function with combined radiation drug application on test animals is shown.

  10. Reduction in radiation-induced brain injury by use of pentobarbital or lidocaine protection

    International Nuclear Information System (INIS)

    Oldfield, E.H.; Friedman, R.; Kinsella, T.; Moquin, R.; Olson, J.J.; Orr, K.; DeLuca, A.M.

    1990-01-01

    To determine if barbiturates would protect brain at high doses of radiation, survival rates in rats that received whole-brain x-irradiation during pentobarbital- or lidocaine-induced anesthesia were compared with those of control animals that received no medication and of animals anesthetized with ketamine. The animals were shielded so that respiratory and digestive tissues would not be damaged by the radiation. Survival rates in rats that received whole-brain irradiation as a single 7500-rad dose under pentobarbital- or lidocaine-induced anesthesia was increased from between from 0% and 20% to between 45% and 69% over the 40 days of observation compared with the other two groups (p less than 0.007). Ketamine anesthesia provided no protection. There were no notable differential effects upon non-neural tissues, suggesting that pentobarbital afforded protection through modulation of ambient neural activity during radiation exposure. Neural suppression during high-dose cranial irradiation protects brain from acute and early delayed radiation injury. Further development and application of this knowledge may reduce the incidence of radiation toxicity of the central nervous system (CNS) and may permit the safe use of otherwise unsafe doses of radiation in patients with CNS neoplasms

  11. Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation

    Energy Technology Data Exchange (ETDEWEB)

    Courtney, Malachi; Ayyagari, Raj R. [Yale School of Medicine, Yale New Haven Hospital, New Haven, CT (United States); Division of Interventional Radiology, Department of Radiology, 789 Howard Avenue, P.O. Box 208042, New Haven, CT (United States)

    2015-06-15

    Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails. (orig.)

  12. Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation

    International Nuclear Information System (INIS)

    Courtney, Malachi; Ayyagari, Raj R.

    2015-01-01

    Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails. (orig.)

  13. Effects of combined radiation-burn injury on survival rate of allogeneic skin grafts and immune reaction in rats

    International Nuclear Information System (INIS)

    Ran Xinze; Yan Yongtang; Cheng Tianmin; Li Yuan; Wei Shuqing

    1996-01-01

    The effects of combined radiation-burn injury on survival rate of allogeneic skin grafts and immune reaction were studied in rats with combined injury of 3-8 Gy 60 Co γ-ray irradiation plus 15% total body surface area full thickness burn induced by exposure to a 5 kw bromotungsten lamp. The allogeneic skin was transplanted 24 hours after injury. It was found that all the skin grafts failed to survive in 10 days and the immune reaction significantly increased in the early stage of burn injury. But the immune reaction was obviously suppressed by the combined radiation-burn injury. The survival rates of skin grafts were 20% and 30% in the combined injury of burn plus 3 and 4 Gy irradiation respectively. When the radiation doses increased to 5,6 and 8 Gy, the survival rates elevated to 69%, 88% and 100% respectively (in the group of 8 Gy, bone marrow transplantation was conducted before receiving skin graft). At day 30 post-transplantation the survival rates were still 36%, 42% and 100% respectively. Compared with burn group, there was a significant difference in survival rate when the radiation doses were higher than 5 Gy. These results indicate that the survival rate of the allogeneic skin graft increases concurrently with the increase in radiation dose and decreases with the elapse of the post-transplantation time

  14. Development and Characterization of VEGF165-Chitosan Nanoparticles for the Treatment of Radiation-Induced Skin Injury in Rats

    Directory of Open Access Journals (Sweden)

    Daojiang Yu

    2016-10-01

    Full Text Available Radiation-induced skin injury, which remains a serious concern in radiation therapy, is currently believed to be the result of vascular endothelial cell injury and apoptosis. Here, we established a model of acute radiation-induced skin injury and compared the effect of different vascular growth factors on skin healing by observing the changes of microcirculation and cell apoptosis. Vascular endothelial growth factor (VEGF was more effective at inhibiting apoptosis and preventing injury progression than other factors. A new strategy for improving the bioavailability of vascular growth factors was developed by loading VEGF with chitosan nanoparticles. The VEGF-chitosan nanoparticles showed a protective effect on vascular endothelial cells, improved the local microcirculation, and delayed the development of radioactive skin damage.

  15. The protective effects of resveratral on acute radiation injury in mice

    International Nuclear Information System (INIS)

    Yan Hao; Wang Hui; Zhang Heng

    2014-01-01

    Objective: To study the protective function of resveratrol on radiation-induced small intestine injury and lethal effect in mice. Methods: Mice were randomly divided into three groups: irradiation (IR) control, IR only, and IR+ resveratrol. 15 mice each group were irradiated on abdomen with 7.2 Gy γ-rays for cell lethal assay and 8 mice each group were irradiated with 6.5 Gy for small intestine injury assay. For the IR+ resveratrol group, the mouse was given resveratrol by intragastric administration 24 h before irradiation and then was fed with resveratrol daily for 5 days. The control and IR alone groups were fed with placebo. After 30 days of IR, mouse survival rate was detected. For small intestine injury experiments, 24 h after IR, the mice were terminated and the small intestines were treated with HE and immunohistochemical staining. Results: Compared with the irradiation group, resveratrol increased mouse survival by 33.3%, decreased apoptosis in intestinal crypt cells (t = 17.35, P < 0.05), and increased Ki67 expression (t = 13.62, P < 0.05). Conclusion: Resveratrol could protect small intestine injury from ionizing irradiation. (authors)

  16. Relation between radiation-induced tissue injury and its carcinogenesis of the rat small intestine

    Energy Technology Data Exchange (ETDEWEB)

    Tsubouchi, S [Aichi Cancer Center, Nagoya (Japan). Research Inst.; Matsuzawa, T

    1975-06-01

    This study was undertaken to make clear the relationships between radiation-induced tissue injury and its carcinogenesis in the rat small intestine. The abdomens of Wistar rats were irradiated locally with 1000 to 2000 rads. Approximately 2 months following irradiation, visible nodules were found in the intestines of the groups receiving irradiation. Nodule incidence was 80 to 100% in groups that received 1750 or 2000 rads, 50% in the 1500-rad groups, and 3% in the 1000-rad groups, respectively. The histology of the nodules within 70 days postirradiation, revealed adenomatous hyperplasia, including invasion of submucosa, muscle layers, and serosa of the small intestine accompanied by an area of fibrous tissue resulting from desmoplastic reaction by irradiation injury. The nodule within 140 to 300 days postirradiation induced advanced tissue injuried, that is, a polypoid lesion in histology and intestinal nodular adhesion in macroscopic anatomy. Running parallel with the advance of the above mentioned tissue injuries, the nodules in 3 out of 18 rat during 200 to 300 days postirradiation showed mucoid adenocarcinoma.

  17. Acute and delayed radiation injuries in the small intestine and colon

    International Nuclear Information System (INIS)

    Heiss, H.

    1981-01-01

    The group of patients with severe actinic intestinal injuries consists of 67 patients, 46 female and 21 male. The main indication of irradiation were gynaecologic tumours with 67%. The irradiation was carried out with a telekobalt unit combined with radium. From the pathogenetic point of view, acute inflammation and necrobiotic processes in the intestinal mucosa and a restriction of the ability to regenerate are the main radiation-induced acute injuries; delayed injuries are mainly the narrowing and rarefaction of the vessels with lacking capillary budding. The cause of the completely different intervals of up to 26 years until the manifestation of the delayed injury remained unclear. The majority of the delayed symptoms were unspecific; therefore, the danger of misinterpretation was pointed out. A resection with primary anastomosis of the ends of the intestines is the goal to be reached operation-technically. The postoperative complication rate was 45.0%. The most frequent complications were the recurrence of a fistula and the formation of a new fistula, respectively, followed by anastomotic and wound insufficiency, and gastrointestinal bleedings. The postoperative lethality was 18.3%. The causes of death were, according to their frequency, peritonitis, acute failure of the coronary circulation, pneumonia, and massive bleedings. (orig./MG) [de

  18. Relation between radiation-induced tissue injury and its carcinogenesis of the rat small intestine

    International Nuclear Information System (INIS)

    Tsubouchi, Susumu; Matsuzawa, Taiju.

    1975-01-01

    This study was undertaken to make clear the relationships between radiation-induced tissue injury and its carcinogenesis in the rat small intestine. The abdomens of Wistar rats were irradiated locally with 1000 to 2000 rads. Approximately 2 months following irradiation, visible nodules were found in the intestines of the groups receiving irradiation. Nodule incidence was 80 to 100% in groups that received 1750 or 2000 rads, 50% in the 1500-rad groups, and 3% in the 1000-rad groups, respectively. The histology of the nodules within 70 days postirradiation, revealed adenomatous hyperplasia, including invasion of submucosa, muscle layers, and serosa of the small intestine accompanied by an area of fibrous tissue resulting from desmoplastic reaction by irradiation injury. The nodule within 140-300 days postirradiation induced advanced tissue injuried, that is, a polypoid lesion in histology and intestinal nodular adhesion in macroscopic anatomy. Running parallel with the advance of the above mentioned tissue injuries, the nodules in 3 out of 18 rat during 200-300 days postirradiation showed mucoid adenocarcinoma. (author)

  19. The effect of pentoxifylline on early and late radiation injury following fractionated irradiation in C3H mice

    Energy Technology Data Exchange (ETDEWEB)

    Dion, M.W.; Hussey, D.H.; Osborne, J.W.

    1989-07-01

    An experiment was performed to test the effectiveness of pentoxifylline in reducing late radiation injury. One hundred and four C3H mice were randomized into eight groups of 13 mice each, and the right hind limbs were irradiated with 4000, 5000, 6000, or 7000 cGy in ten fractions. Each group was treated with once daily injections of either pentoxifylline or saline for 30+ weeks. An additional ten mice received daily injections of pentoxifylline or saline, but no irradiation. The pentoxifylline animals demonstrated significantly less late injury than the saline treated animals. The most obvious differences were observed in the 5000 and 6000 cGy groups. There were seven radiation related deaths in the saline treated control groups, but only one radiation related death in the pentoxifylline treated groups. Whereas 42% (20/48) of the saline treated animals had a late injury score of 3.0 or greater, only 8% (4/51) of the pentoxifylline treated animals had a late skin score as high as 3.0. Pentoxifylline had no effect on the acute radiation injury scores. The drug was well tolerated with no toxic effects noted. Pentoxifylline is a methyl xanthine derivative that is used to treat vascular occlusive disease in humans. It improves perfusion through small capillaries by improving the deformability of red blood cells, inhibiting platelet aggregation, and stimulating the release of prostacyclin. This study shows that the prophylactic administration of pentoxifylline can modify late radiation induced injury in the mouse extremity. It may have value in the prevention or treatment of late radiation induced injury in humans, and it could be a useful tool to help define the mechanisms of late radiation injury in specific organs.

  20. The effect of pentoxifylline on early and late radiation injury following fractionated irradiation in C3H mice

    International Nuclear Information System (INIS)

    Dion, M.W.; Hussey, D.H.; Osborne, J.W.

    1989-01-01

    An experiment was performed to test the effectiveness of pentoxifylline in reducing late radiation injury. One hundred and four C3H mice were randomized into eight groups of 13 mice each, and the right hind limbs were irradiated with 4000, 5000, 6000, or 7000 cGy in ten fractions. Each group was treated with once daily injections of either pentoxifylline or saline for 30+ weeks. An additional ten mice received daily injections of pentoxifylline or saline, but no irradiation. The pentoxifylline animals demonstrated significantly less late injury than the saline treated animals. The most obvious differences were observed in the 5000 and 6000 cGy groups. There were seven radiation related deaths in the saline treated control groups, but only one radiation related death in the pentoxifylline treated groups. Whereas 42% (20/48) of the saline treated animals had a late injury score of 3.0 or greater, only 8% (4/51) of the pentoxifylline treated animals had a late skin score as high as 3.0. Pentoxifylline had no effect on the acute radiation injury scores. The drug was well tolerated with no toxic effects noted. Pentoxifylline is a methyl xanthine derivative that is used to treat vascular occlusive disease in humans. It improves perfusion through small capillaries by improving the deformability of red blood cells, inhibiting platelet aggregation, and stimulating the release of prostacyclin. This study shows that the prophylactic administration of pentoxifylline can modify late radiation induced injury in the mouse extremity. It may have value in the prevention or treatment of late radiation induced injury in humans, and it could be a useful tool to help define the mechanisms of late radiation injury in specific organs

  1. Elemental diet as prophylaxis against radiation injury. Histological and ultrastructural studies

    International Nuclear Information System (INIS)

    McArdle, A.H.; Wittnich, C.; Freeman, C.R.; Duguid, W.P.

    1985-01-01

    The authors investigated whether elemental diet feeding would protect the intestine from radiation injury. Five dogs were fed an elemental diet for three days before receiving pelvic irradiation (500 rad/day for four days) and were maintained on the diet during the days of irradiation. These dogs were compared with five dogs that were fed normal kennel ration, but were treated similarly otherwise. One day and five days following completion of the radiation treatment, the dogs were anesthetized and a biopsy specimen of terminal ileum was taken for histologic and electron microscopic studies. In the dogs fed the elemental diet, there was no significant damage to the intestine seen on histological examination, and electron microscopy disclosed elongated microvilli and no organelle damage. However, both histological and electron microscopic examination of the intestine from dogs maintained on normal kennel ration showed that severe damage had occurred from the irradiation procedure. It seems, therefore, that the feeding of an elemental diet to dogs as a prophylaxis can afford protection to the intestine from the acute phase of radiation injury

  2. Collections of laws and ordinances concerning radiation injury prevention as of July 24, 1981

    International Nuclear Information System (INIS)

    Tsuruta, Takao

    1981-01-01

    There are laws, government and ministerial ordinances and notifications, each of them bears a definite role, and the contents of the legal regulation on a certain range of matter are determined by their close interrelation and mutual supplementation. Many laws and ordinances concerning atomic energy also form a legal system under such mutual relation. The Atomic Energy Act is positioned at its top, and the main part related to radiation injury prevention comprises a law, two ordinances, a regulation and a notification. Such relationship of individual laws and ordinances is mostly shown in lower rank laws and ordinances. In Chapter 1 of this book, the Atomic Energy Act and the government ordinance concerning the definition of nuclear fuel materials, nuclear raw materials, nuclear reactors and radiation are described. In Chapter 2, the law concerning prevention of radiation injuries due to radiactive isotopes and others, the ordinances and eight notifications closely related to them are collected. In Chapter 3, other related laws and ordinances are gathered. To understand the laws and ordinances synthetically and systematically, the provisions of different laws and ordinances, which are mutually related, are arranged together showing their relation. (Kako, I.)

  3. Opportunity for Collaboration Between Radiation Injury Treatment Network Centers and Medical Toxicology Specialists.

    Science.gov (United States)

    Davlantes, Elizabeth; Shartar, Samuel; Venero, Jennifer; Steck, Alaina; Langston, Amelia; Kazzi, Ziad N

    2017-08-01

    The Radiation Injury Treatment Network (RITN) comprises >50 centers across the United States that are poised to care for victims of a radiation emergency. The network is organized around bone marrow transplant centers because these facilities excel in both radiation medicine and the care of patients with severe bone marrow depression. A radiation emergency may cause not only irradiation from an external source but also internal contamination with radioactive material. Because medical toxicologists are trained in radiation injury management and have expertise in the management of internal contamination, RITN centers may benefit from partnerships with medical toxicology resources, which may be located at academic medical centers, hospital inpatient clinical services, outpatient clinics, or poison control centers. We determined the locations of existing RITN centers and assessed their proximity to various medical toxicology resources, including medical toxicology fellowship programs, inpatient toxicology services, outpatient toxicology clinics, and poison control centers. Data were derived from publicly available Internet sources in March 2015. The majority of RITN centers do not have a medical toxicology fellowship, an inpatient toxicology service, or an outpatient toxicology clinic within the same institution. Fifty-seven percent of RITN centers have at least one of these resources located in the same city, however, and 73% of centers have at least one of these resources or a poison control center within the same city. Ninety-five percent of RITN centers have at least one medical toxicology resource within the state. Most RITN centers are located in the same city as at least one medical toxicology resource. Establishing relationships between RITN centers and medical toxicologists needs to be explored further.

  4. Mitigation of radiation induced hematopoietic injury via regulation of Nrf-2 and increasing hematopoietic stem cells

    International Nuclear Information System (INIS)

    Patwardhan, R.S.; Sharma, Deepak; Checker, Rahul; Santosh Kumar, S.

    2014-01-01

    Therapeutic doses of ionizing radiation (IR) that can be delivered to tumors are restricted due to radiation induced damage to surrounding normal tissues thereby limiting the effectiveness of radiotherapy. Strategies to develop agents that selectively protect normal cells yielded limited success in the past. There is pressing need to develop safe, syndrome specific and effective radiation countermeasures to prevent or mitigate the harmful consequences of radiation exposure. Survival of bone marrow stem cells (HSCs) play a key role in protecting against IR induced hematopoietic injury. Many studies have shown manipulation of HSC frequency and/or survival as principal mechanism of radioprotection. It is known that, Nrf-2 plays crucial role in HSC survival and maintenance under oxidative stress conditions. In the present study, we have investigated the radioprotective ability of a flavonoid baicalein (5,6,7-trihydroxyflavone), extracted from the root of Scutellaria baicalensis Georgi, a medicinal plant traditionally used in Oriental medicine. There are numerous reports showing anti-inflammatory, anti-apoptotic, anti-oxidant, anti-cancer, anti-microbial, anti-mutagenic and neuroprotective properties of baicalein. Based on these reports, we have investigated the ability of baicalein to protect against radiation induced hematopoietic injury. Baicalein administration to mice protected against WBI induced mortality. Interestingly, the stem cell frequency increased in bone marrow cells obtained from baicalein administered mice as compared to vehicle treated mice. Baicalein treatment led to increased phospho-Nrf-2 levels in lineage negative BM-MNC. Administration of mice with Nrf-2 inhibitor prior to baicalein treatment led to significant abrogation of radioprotective ability of baicalein. This result suggests that, Nrf-2 may be playing a key role in baicalein mediated radioprotection. Here, we have shown that baicalein administration augments stem cell frequency, induces

  5. Treatment-time-dependence models of early and delayed radiation injury in rat small intestine

    International Nuclear Information System (INIS)

    Denham, James W.; Hauer-Jensen, Martin; Kron, Tomas; Langberg, Carl W.

    2000-01-01

    Background: The present study modeled data from a large series of experiments originally designed to investigate the influence of time, dose, and fractionation on early and late pathologic endpoints in rat small intestine after localized irradiation. The objective was to obtain satisfactory descriptions of the regenerative response to injury together with the possible relationships between early and late endpoints. Methods: Two- and 26-week pathologic radiation injury data in groups of Sprague-Dawley rats irradiated with 27 different fractionation schedules were modeled using the incomplete repair (IR) version of the linear-quadratic model with or without various time correction models. The following time correction models were tested: (1) No time correction; (2) A simple exponential (SE) regenerative response beginning at an arbitrary time after starting treatment; and (3) A bi-exponential response with its commencement linked to accumulated cellular depletion and fraction size (the 'intelligent response model' [INTR]). Goodness of fit of the various models was assessed by correlating the predicted biological effective dose for each dose group with the observed radiation injury score. Results: (1) The incomplete repair model without time correction did not provide a satisfactory description of either the 2- or 26-week data. (2) The models using SE time correction performed better, providing modest descriptions of the data. (3) The INTR model provided reasonable descriptions of both the 2- and 26-week data, confirming a treatment time dependence of both early and late pathological endpoints. (4) The most satisfactory descriptions of the data by the INTR model were obtained when the regenerative response was assumed to cease 2 weeks after irradiation rather than at the end of irradiation. A fraction-size-dependent delay of the regenerative response was also suggested in the best fitting models. (5) Late endpoints were associated with low-fractionation sensitivity

  6. Effect of collagen type IV, MMPs and TIMPs on remodeling of radiation pulmonary injury

    International Nuclear Information System (INIS)

    Diao Ruiying; Song Liangwen; Wang Shaoxia; Yin Jiye

    2007-01-01

    Objective: To explore the effect of collagen type IV, matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs(TIMPs) on early remodeling after radiation pulmonary injury. Methods: Right lungs of rats were irradiated by 60 Co γ-rays at a dose of 20 Gy to induce radiation pulmonary injury, and the lung specimens were taken at weeks 1, 2, 4 after irradiation. Quantitative analysis was performed on pulmonary collagen type IV, MMP-2, MMP-9, TIMP-2, TIMP-1 at the level of gene expression and protein synthesis using real-time PCR or immunohistochemistry. Results: Gene detection using real-time PCR: gene expression of collagen type IV increased at week 1 and decreased at week 2 after irradiation; MMP-2 reached peak at week 2 in which an opposed alteration trend was displayed; MMP-9 appeared a significant trend of elevation, then decrease and elevation again which was similar to those of collagen type IV; expression of TIMP-1 was lower, and there was no marked difference among all time points; TIMP-2 displayed a trend of slight elevation, then decrease and elevation again, which was opposed to MMP-2. Immunohistochemistry-image analysis: Pulmonary collagen type IV obviously increased at week 1, and began to decrease at week 2; MMP-2 decreased at week 2 and then increased; an opposed alteration trend to that of collagen type IV was displayed; alteration trend of MMP-9 was similar to that of collagen type IV but the extent was higher; gene expression of TIMP-1 slightly increased at 2 week and an opposed trend to of MMP-9 was displayed. Conclusions: Collagen type IV, MMP-2, MMP-9 and their tissue inhibitors were involved in ineffective remodeling in the early radiation pulmonary injury; MMP-2 and MMP-9 play an important role in degradation of collagen type IV; Disturbance of collagen type IV degradation might have relationship with the initiation of pulmonary fibrosis. (authors)

  7. Different imaging methods in the assessment of radiation-induced lung injury following hemithorax irradiation for pleural mesothelioma

    International Nuclear Information System (INIS)

    Maasilta, P.; Kivisaari, L.; Mattson, K.

    1990-01-01

    The authors have characterized the radiation-induced lung-injury on serial chest X-rays, CTs and ultralow field MRs and evaluated the clinical value and cost/benefit ratio of the different imaging methods in 30 patients receiving high-dose hemithorax irradiation for pleural mesothelioma. Lung injury was severe in all patients, but non-specific and essentially as described in text-books. CT provided no clinically relevant, cost effective diagnostic advantage over conventional X-rays in the detection of early or late radiation-induced lung injury, but it was necessary for the evaluation of the disease status of the mesothelioma. The possible advantage of MR over CT could not be evaluated and needs further studies. Optimal time-points for imaging CTs or MRs to detect early radiation-induced lung injury following high dose hemithorax irradiation were during the latter part of the treatment or very shortly after the end of the irradiation. Late injury or irreversible fibrosis develop rapidly after 6 months and was clearly documented by chest X-rays. The authors recommend serial chest X-rays at 1-2, 6 and 12 months following radiotherapy as a cost-effective method for the detection of radiation-induced lung injury with additional CTs to document the stage of mesothelioma, when needed. (author). 31 refs.; 4 figs

  8. Radiation and the lung: a reevaluation of the mechanisms mediating pulmonary injury

    International Nuclear Information System (INIS)

    Morgan, Graeme W.; Breit, Samuel N.

    1995-01-01

    scan uptake in patients studied before and 4 to 6 weeks after strictly unilateral lung irradiation. This is suggestive of a hypersensitivity pneumonitis, which gives rise to an 'out-of-field' response to localized lung irradiation and hence more accurately describes the clinical picture of radiation pneumonitis. Reevaluation of the mechanisms of pulmonary injury from irradiation suggest that (a) a new term, sporadic radiation pneumonitis, should be introduced to describe the clinical picture of radiation pneumonitis, which is not adequately explained by the classical description and is quite clearly an entirely different process; and (b) that the chronic response to localized lung irradiation that leads to pulmonary fibrosis is largely mediated through the induction and release of tissues cytokines

  9. Selenoprotein P Inhibits Radiation-Induced Late Reactive Oxygen Species Accumulation and Normal Cell Injury

    Energy Technology Data Exchange (ETDEWEB)

    Eckers, Jaimee C.; Kalen, Amanda L.; Xiao, Wusheng; Sarsour, Ehab H.; Goswami, Prabhat C., E-mail: prabhat-goswami@uiowa.edu

    2013-11-01

    Purpose: Radiation is a common mode of cancer therapy whose outcome is often limited because of normal tissue toxicity. We have shown previously that the accumulation of radiation-induced late reactive oxygen species (ROS) precedes cell death, suggesting that metabolic oxidative stress could regulate cellular radiation response. The purpose of this study was to investigate whether selenoprotein P (SEPP1), a major supplier of selenium to tissues and an antioxidant, regulates late ROS accumulation and toxicity in irradiated normal human fibroblasts (NHFs). Methods and Materials: Flow cytometry analysis of cell viability, cell cycle phase distribution, and dihydroethidium oxidation, along with clonogenic assays, were used to measure oxidative stress and toxicity. Human antioxidant mechanisms array and quantitative real-time polymerase chain reaction assays were used to measure gene expression during late ROS accumulation in irradiated NHFs. Sodium selenite addition and SEPP1 overexpression were used to determine the causality of SEPP1 regulating late ROS accumulation and toxicity in irradiated NHFs. Results: Irradiated NHFs showed late ROS accumulation (4.5-fold increase from control; P<.05) that occurs after activation of the cell cycle checkpoint pathways and precedes cell death. The mRNA levels of CuZn- and Mn-superoxide dismutase, catalase, peroxiredoxin 3, and thioredoxin reductase 1 increased approximately 2- to 3-fold, whereas mRNA levels of cold shock domain containing E1 and SEPP1 increased more than 6-fold (P<.05). The addition of sodium selenite before the radiation treatment suppressed toxicity (45%; P<.05). SEPP1 overexpression suppressed radiation-induced late ROS accumulation (35%; P<.05) and protected NHFs from radiation-induced toxicity (58%; P<.05). Conclusion: SEPP1 mitigates radiation-induced late ROS accumulation and normal cell injury.

  10. The burning issues of motor vehicle radiator scald injuries revisited - a fresh review and changing prevention strategies.

    Science.gov (United States)

    Patel, J N; Tan, A; Frew, Q; Dziewulski, P

    2016-12-31

    A preventable subgroup of burn injuries is scalds sustained from motor vehicle radiators. This study was to determine changes in trends in epidemiology of such injuries and to discuss whether current and other prevention efforts proposed previously require reinforcement. We conducted a retrospective study (February 2007-August 2015) of all motor vehicle-related burn referrals to our regional burns service. 68 cases of motor vehicle radiator burns were identified. Male to female ratio was 65:3. Mean age was 35.1 (range = 9-71). Most cases occurred in the summer months (22/68 = 32.4%). 65 cases (95.6%) involved car radiators. 66% of injuries resulted from actively removing the pressure cap of an overheated radiator in the motor vehicle. Mean total burn surface area (%TBSA) was 2.1% (range = 0.5- 11%). The depths of burn injuries were mostly superficial partial thickness. Face, chest and upper limbs were the most common sites of injury. Mean healing time was 14.2 days (range = 4-60). Following the introduction of safety measures by vehicle manufacturers, motor vehicle radiator burns in this era are mostly minor injuries and can be potentially managed conservatively as an outpatient. This contrasts with findings from previous studies over a decade ago of larger, more significant injuries requiring admission and surgery. Whilst manufacturers have installed safety measures into the design of radiator caps, our findings suggest that re-educating the public to allow a period of cooling prior to opening caps should be reinforced.

  11. The burning issues of motor vehicle radiator scald injuries revisited – a fresh review and changing prevention strategies

    Science.gov (United States)

    Patel, J.N.; Tan, A.; Frew, Q.; Dziewulski, P.

    2016-01-01

    Summary A preventable subgroup of burn injuries is scalds sustained from motor vehicle radiators. This study was to determine changes in trends in epidemiology of such injuries and to discuss whether current and other prevention efforts proposed previously require reinforcement. We conducted a retrospective study (February 2007-August 2015) of all motor vehicle-related burn referrals to our regional burns service. 68 cases of motor vehicle radiator burns were identified. Male to female ratio was 65:3. Mean age was 35.1 (range = 9-71). Most cases occurred in the summer months (22/68 = 32.4%). 65 cases (95.6%) involved car radiators. 66% of injuries resulted from actively removing the pressure cap of an overheated radiator in the motor vehicle. Mean total burn surface area (%TBSA) was 2.1% (range = 0.5- 11%). The depths of burn injuries were mostly superficial partial thickness. Face, chest and upper limbs were the most common sites of injury. Mean healing time was 14.2 days (range = 4-60). Following the introduction of safety measures by vehicle manufacturers, motor vehicle radiator burns in this era are mostly minor injuries and can be potentially managed conservatively as an outpatient. This contrasts with findings from previous studies over a decade ago of larger, more significant injuries requiring admission and surgery. Whilst manufacturers have installed safety measures into the design of radiator caps, our findings suggest that re-educating the public to allow a period of cooling prior to opening caps should be reinforced. PMID:28289357

  12. Plasma amylase activity as a biochemical indicator of radiation injury to salivary glands

    Energy Technology Data Exchange (ETDEWEB)

    Becciolini, A; Giannardi, G; Cionini, L; Porciani, S; Fallai, C; Pirtoli, L [Florence Univ. (Italy). Ist. di Radiologia

    1984-01-01

    Irradiation of the salivary glands produces a rapid increase of salivary amylase in serum, released by the highly radiation sensitive serous cells of the glands. Serial assays of salivar