응급의학과 의사의 방사선 피폭에 대한 인지도 조사

오상훈,최세민,이미진,박규남,최승필,김영민,소병학,김한준,조영순,홍태용 대한응급의학회 2008 대한응급의학회지 Vol.19 No.5

Purpose: Emergency physicians (EPs) are exposed to radiation in the emergency department (ED). However, EPs are not followed with dosimeter measurements of radiation exposure because of the common belief that EPs have a low exposure to radiation. This study was performed to investigate the recognition of EPs’ level of radiation exposure. Methods: Data were collected from direct interviews with questionnaires administered at five ED’s medical conference from November, 2007 to March, 2008. One hundred and twenty-one EPs were surveyed with questionnaires. The questionnaires consisted of six items on the patient characteristics, rate of radiation exposure, recognition of radiation exposure, knowledge of radiation exposure, patient exposure, and education. Some questions were graded on a five point Likert scale. The average and standard deviation were calculated. Results: There were 58.3% of the EPs that reported that they were exposed to portable X-rays more than three times per day; 58.8% of the answers showed that the EPs did not escape from exposure to the portable X-rays. For 87.3% of the EPs, they did not wear lead aprons during the portable X-rays. There were 51.1% of answers that severely underestimated the radiation dose from a CT. The recognition and knowledge of radiation exposure among ED residents increased as there level of training increased, but this was not the case for the board certified emergency physicians (p=0.016). The radiation exposure to the patients was not accurately estimated by EP scores, regardless of their level of experience. Conclusion: The lack of knowledge and recognition of the exposure to radiation by EPs expose them and their patients to potentially dangerous levels of radiation that might increase their lifetime cancer risk. We recommend that EPs should be educated regarding their radiation exposure as well as their patients and followed by dosimeter evaluations to minimize radiation exposure.

의료기관 핵의학 종사자의 직무 별 개인피폭선량에 관한 연구

강천구,오기백,박훈희,오신현,박민수,김정열,이진규,나수경,김재삼,이창호,Kang, Chun-Goo,Oh, Ki-Baek,Park, Hoon-Hee,Oh, Shin-Hyun,Park, Min-Soo,Kim, Jung-Yul,Lee, Jin-Kyu,Na, Soo-Kyung,Kim, Jae-Sam,Lee, Chang-Ho 대한핵의학기술학회 2010 핵의학 기술 Vol.14 No.2

Purpose: With increasing medical use of radiation and radioactive isotopes, there is a need to better manage the risk of radiation exposure. This study aims to grasp and analyze the individual radiation exposure situations of radiation-related workers in a medical facility by specific job, in order to instill awareness of radiation danger and to assist in safety and radiation exposure management for such workers. Materials and Methods: 1 January 2007 to 31 December 2009 to work in medical institutions are classified as radiation workers Nuclear personal radiation dosimeter regularly, continuously administered survey of 40 workers in three years of occupation to target, Imaging Unit beautifully, age, dose sector, job function-related tasks to identify the average annual dose for a deep dose, respectively, were analyzed. The frequency analysis and ANOVA analysis was performed. Results: Imaging Unit beautifully three years the annual dose PET and PET/CT in the work room 11.06~12.62 mSv dose showed the highest, gamma camera injection room 11.72 mSv with a higher average annual dose of occupation by the clinical technicians 8.92 mSv the highest, radiological 7.50 mSv, a nurse 2.61 mSv, the researchers 0.69 mSv, received 0.48 mSv, 0.35 mSv doctors orderly, and detail work employed the average annual dose of the PET and PET/CT work is 12.09 mSv showed the highest radiation dose, gamma camera injection work the 11.72 mSv, gamma camera imaging work 4.92 mSv, treatment and safety management and 2.98 mSv, a nurse working 2.96 mSv, management of 1.72 mSv, work image analysis 0.92 mSv, reading task 0.54 mSv, with receiving 0.51 mSv, 0.29 mSv research work, respectively. Dose sector average annual dose of the study subjects, 15 people (37.5%) than the 1 mSv dose distribution and 5 people (12.5%) and 1.01~5.0 mSv with the dose distribution was less than, 5.01~10.0 mSv in the 14 people (35.0%), 10.01~20.0 mSv in the 6 people (15.0%) of the distribution were analyzed. The average annual dose according to age in occupations that radiological workers 25~34 years old have the highest average of 8.69 mSv dose showed the average annual dose of tenure of 5~9 years in jobs radiation workers in the 9.5 mSv The average was the highest dose. Conclusion: These results suggest that medical radiation workers working in Nuclear Medicine radiation safety management of the majority of the current were carried out in the effectiveness, depending on job characteristics has been found that many differences. However, this requires efforts to minimize radiation exposure, and systematic training for them and for reasonable radiation exposure management system is needed.

방사선 데이터의 활용 가능성

정지홍 한국기초조형학회 2013 기초조형학연구 Vol.14 No.2

This research was aimed at transferring radiation information with speed and understandings, and also renew the current perception of radiation. In order to achieve this, cases of visualization of the data that was based on physical computing was looked into, created a Visible Radiation Cube to monitor the environment data that is usually invisible, and visualized the radiation data through this equipment. The results showed that in terms of modern new media art, there was a huge potential that it would trigger great interest in lots of people with numerous visual effects by expressing graphical data in a more physical form in a digital area through phyusical computing, and it can act as the new for of media. Also, as a visual tool for visualizing environmental data like radiation, the potential of physical computing was reassured. Through the installation of Visible Radiation Cube, the radiation data that is acquired in real time can be visualized through the brightness of the LED with other radiation information, and therefore anyone can see the current radiation information. Through this, the radiation information that seemed abstract can now be displayed in detail and the effective transfer of information had enabled direct understanding. The visualization of the environment data meant much more than letting the public visually see information like the radiation data that they could not otherwise see. With accomplishing the object of increasing the speed of data being understood, it is safe to state that it showed the potential to change the view on radiation and nuclear power that will eventually influence the society. 본 연구는 방사선 정보의 빠른 전달과 이해, 그리고 방사선에 대한 인식을 환기시키기 위함에 있다. 이를 위해 피지컬 컴퓨팅을 기반으로 한 데이터 시각화의 사례를 살펴보고, 방사능이라는 눈에 보이지 않는 환경데이터를 Visible Radiation Cube의 제작, 설치를 통하여 방사선 데이터를 시각적으로 재현하였다. 연구결과, 현재 뉴미디어 아트에 있어서 피지컬 컴퓨팅의 디지털 공간에서의 그래픽적인 데이터시각화에서 벗어나 현실공간에서의 물리적 표현은 정보에 감성을 부여하여 보는 사람들에게 흥미 유발과 다양한 시각적 효과를 기대할 수 있고, 새로운 정보매체로서의 기능을 할 수 있다. 또한 피지컬 컴퓨팅은 방사선과 같은 환경데이터의 시각화 도구로서의 가능성을 확인할 수 있었다. Visible Radiation Cube의 설치를 통해, 실시간으로 얻어지는 방사선 데이터 수치를 LED의 점등량과 판단 기준이 되는 다른 방사선 정보와 함께 시각화함으로써 누구라도 간단히 현재의 방사선 정보를 파악할 수 있는 것을 볼 수 있었다. 이로 인해, 추상적으로 느껴졌던 방사선 정보가 구체적인 정보로서 가치와 역할을 할 수 있게 되었고, 효과적인 정보전달과 직관적인 이해를 가능하게 할 수 있음을 알 수 있었다. 사람들이 지각하지 못하고 흘려보낼 수도 있었던 방사선을 비롯한 환경데이터의 시각화는 단순한 정보의 전달과 취득, 빠른 이해라는 목적을 넘어서, 방사선과 원자력, 환경오염 등과 같은 환경 데이터에 대한 인식의 변화를 유도함으로써 사회에 영향을 미치는 역할을 기대해 볼 수 있다.

Radiation Induced Lung Injury: Prediction, Assessment and Management

Giridhar, Prashanth,Mallick, Supriya,Rath, Goura Kishore,Julka, Pramod Kumar Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.7

Radiation induced lung injury has long been considered a treatment limiting factor for patients requiring thoracic radiation. This radiation induced lung injury happens early as well as late. Radiation induced lung injury can occur in two phases viz. early (< 6 months) when it is called radiation pneumonitis and late (>6 months) when it is called radiation induced lung fibrosis. There are multiple factors that can be patient, disease or treatment related that predict the incidence and severity of radiation pneumonitis. Radiation induced damage to the type I pneumocytes is the triggering factor to initiate such reactions. Over the years, radiation therapy has witnessed a paradigm shift in radiation planning and delivery and successfully reduced the incidence of lung injury. Radiation pneumonitis is usually a diagnosis of exclusion. Steroids, ACE inhibitors and pentoxyphylline constitute the cornerstone of therapy. Radiation induced lung fibrosis is another challenging aspect. The pathophysiology of radiation fibrosis includes continuing inflammation and microvascular changes due to pro-angiogenic and profibrogenic stimuli resembling those in adult bronchiectasis. General supportive management, mobilization of airway secretions, anti-inflammatory therapy and management of acute exacerbations remains the treatment option. Radiation induced lung injury is an inevitable accompaniment of thoracic radiation.

치과 의료기관의 방사선 안전관리 지침서 개발의 필요성

황소라 ( So Ra Hwang ) 대한예방치과·구강보건학회 2019 대한구강보건학회지 Vol.43 No.2

Objectives: The objectives of this study were to determine the radiation safety status of dental care institutions and to contribute to the development of guidelines for radiation protection in dental clinics in order to improve the work environment and reduce the radiation hazard for practitioners. Methods: The subjects were selected using a convenience sampling. A total of 300 subjects participated in this study, including 150 dental hygienists from dental clinics in Gwangju Metropolitan City with radiation-related work experience and 150 dental hygienists who had participated in a seminar hosted by the Korean Dental Insurance Manager Association held on January 17, 2016. For the survey, self-entry questionnaires were used, and the collected data were analyzed by performing a frequency analysis using cross tabulation (c2-test) and t-test, one-way analysis of variance, and multiple regression analysis. Results: The awareness on radiation protection among dental hygienists showed 4.4 out of 5 points, which was high, but the practice of radiation protection was overall poor. For the necessity of developing radiation protection guidelines, 91.9% answered “Yes, it is necessary.”. Conclusions: The level of radiation protection practiced at dental healthcare centers was much lower than the awareness of it and showed that the requirement of guidelines for radiation protection was high. Therefore, institutional devices require the development and utilization of various types of radiation protection guidelines in order to mitigate radiation risks and improve the work environment.

Research on Reducing Radiation Exposure for Clinical Applications of X-ray Attenuation

전민철,한만석,소운영,이현국,김용균,이승열 한국물리학회 2014 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.64 No.4

This study was aimed at identifing areas with low radiation exposure where workers could be takenin the examination room in case that they had to hold the patients by estimating the attenuationof primary radiation and measuring the spatial distribution of scattered radiation. The laboratoryequipment included on the X-ray generator, a phantom (human phantom), and a dosimeter. Theexperiment measured the performance of the examination system (dose reproducibility), the doseof primary radiation (X-rays), and the dose of scattered radiation (secondary radiation). Both theprimary and the scattered radiation were attenuated by a factor of tube in vacuum experimentaltests of the inverse square law. In this study, the attenuation was 2 2.246 for primary radiationand 2 2.105 for secondary radiation. Natural attenuation occurred as the X-rays passed throughair, and an attenuation equation was established in this study. The equation for primary radiation(1st dose) was y = A1 exp(−x/t1)+y0. The high-intensity contour of the direction for the cathodewas wider than that of the direction for the anode, showing a wide range on the rear side of thecathode and on the rear side of the anode. We tried to find the positions where the workers’radiation exposure could be reduced. When the medical radiation workers have to hold the patientfor an abdominal examination, they should be placed towards the tube anode and on the left sideof the patient. For a lumbar-spine lateral examination, they should be placed towards the tubeanode and behind the patient, and for a femur AP (anterior-posterior) examination, they shouldbe placed towards the tube anode and on the right side of the patient.

Protective Effects of N-Acetylcysteine against Radiation-Induced Oral Mucositis In Vitro and In Vivo

김행준,강성운,이윤상,장전엽,Hami Kang,김철호 대한암학회 2020 Cancer Research and Treatment Vol.52 No.4

Purpose Radiation-induced oral mucositis limits delivery of high-dose radiation to targeted cancers. Therefore, it is necessary to develop a treatment strategy to alleviate radiation-induced oral mucositis during radiation therapy. We previously reported that inhibiting reactive oxygen species (ROS) generation suppresses autophagy. Irradiation induces autophagy, suggesting that antioxidant treatment may be used to inhibit radiation-induced oral mucositis. Materials and Methods We determined whether treatment with N-acetyl cysteine (NAC) could attenuate radiation-induced buccal mucosa damage in vitro and in vivo. The protective effects of NAC against oral mucositis were confirmed by transmission electron microscopy and immunocytochemistry. mRNA and protein levels of DNA damage and autophagy-related genes were measured by quantitative real-time polymerase chain reaction and western blot analysis, respectively. Results Rats manifesting radiation-induced oral mucositis showed decreased oral intake, loss of body weight, and low survival rate. NAC intake slightly increased oral intake, body weight, and the survival rate without statistical significance. However, histopathologic characteristics were markedly restored in NAC-treated irradiated rats. LC3B staining of rat buccal mucosa revealed that NAC treatment significantly decreased the number of radiation-induced autophagic cells. Further, NAC inhibited radiation-induced ROS generation and autophagy signaling. In vitro, NAC treatment significantly reduced the expression of NRF2, LC3B, p62, and Beclin-1 in keratinocytes compared with that after radiation treatment. Conclusion NAC treatment significantly inhibited radiation-induced autophagy in keratinocytes and rat buccal mucosa and may be a potentially safe and effective option for the prevention of radiation-induced buccal mucosa damage.

의료용 선형 가속기 종류에 따른 방사선 치료기법에 대한 분석

김염재 ( Young Jae Kim ),동경래 ( Kyung Rae Dong ),여화연 ( Hwa Yeon Yeo ) 조선대학교 공학기술연구원 2012 공학기술논문지 Vol.5 No.3

The use of radiation therapy continues today as a treatment for cancer in radiation therapy devices. This study will be focused on the characteristics of medical radiation devices for the radiation oncology field. Clinac IX was developed or validated by Varian; it was com­bined with Intensity modulated Radiation Therapy (lMRT), Image-Guided Radiation Therapy (lGRT), and on board imaging that allow us to provide our patients with advanced radiation ther­apy. Varian Clinac IX linear accelerators capable of imaging cancerous tumor treatment areas during the actual process of radiation treatment, a process known a linage-Guided Radiation Therapy, or IMRT. Artiste CT Vision developed by Simens IMRT and IGRT. CT is able to pre­cise location of the internal organs in the cancer patients. Novalis TXTM is radiation treatment machine; the Novalis TxTM can treat many different types of cancer. Treatment table (Cauch)`s movement was wider than other devices. However, it has the disadvantage that it is more expensive than other device. Tomotherapy treatment equipment is likely to IMRT, IGRT treatment technique. However, before treatment it causes unnecessary patient exposure to radiation. As a result all the equipment studied here most1y available treatment techniques. Thus, when the introduction of new radiation therapy equipment in the hospital, which is imple­mented based on the treatment technique cost and patient care.

악성 폐종양의 사이버나이프 방사선수술 후 방사선 폐손상의 CT 소견

서재영,조영준,이선영,김금원,황철목,김대호,김호준 대한영상의학회 2011 대한영상의학회지 Vol.65 No.3

Purpose: To evaluate the CT appearance of radiation-induced pulmonary injury in patients who have undergone cyberknife radiosurgery for lung malignancy. Materials and Methods: Thirty-four patients with 39 malignant lung tumors who underwent cyberknife radiosurgery were enrolled for evaluation. A total of 24-60 Gy was administered in 3 fractions. We evaluated the CT appearance of radiation pneumonitis and radiation fibrosis. We also evaluated the location of radiation pneumonitis and the minimal dose which causes radiation pneumonitis. Results: Radiation pneumonitis and radiation fibrosis occurred in 95% and 90% of cases, respectively. CT patterns of radiation pneumonitis demonstrated 20 cases (54%) as ground glass opacities (GGO). GGO included only 7 cases (19%), while 6 cases (16%) had patchy consolidations and 4 cases (11%) were diffuse consolidations, respectively. Radiation pneumonitis demonstrated 30 cases (81%) as concentric patterns surrounding the tumor, while 7 cases (19%) included the eccentric patterns. The radiation pneumonitis appeared within the 13-38 Gy (mean 21 Gy). CT findings of radiation fibrosis demonstrated as the modified conventional patterns, which decreased to 17 cases (65%), while 7 cases (27%) had mass-like patterns and 2 cases (8%) had scar-like patterns, respectively. Conclusion: Radiation pneumonitis after cyberknife radiosurgery commonly develops as concentric patterns surrounding a tumor. The mass-like pattern of radiation fibrosis was sometimes difficult to distinguish from tumor recurrence. Thus, knowledge of the CT finding of radiation-induced lung injury might be helpful in distinguishing pulmonary changes from tumor recurrence. 목적: 악성 폐종양으로 사이버나이프 방사선수술을 받은 환자들에서 방사선 폐손상의 CT 소견에 대해 분석하고자 하였다. 대상과 방법: 본원에서 사이버나이프 방사선수술을 시행 받은 34명의 환자의 39개 악성 폐종양을 대상으로 하였다. 모든 환자는 총방사선량 24~60 Gy(평균 50 Gy)를 3회 분할하여 치료하였다. 방사선폐렴의 CT 소견은 방사선 조사부위 폐의 간유리 음영과 경화의 존재로 평가하였고, 방사선섬유증은 경화, 견인성 기관지확장증 그리고 폐용적 감소의 여부로 평가하였다. 또한 추적 CT에서 방사선폐렴의 위치와 발생하는 부위의 최소 방사선량을 각각 평가하였다. 결과: 방사선폐렴과 방사선섬유증은 각각 95%(37/39)와 90%(26/29)에서 발생하였다. 방사선폐렴의 CT 소견은 간유리 음영과 경화의 혼합음영이 20예(54%), 간유리음영이 7예(19%), 반점상경화 6예(16%), 미만성경화 4예(11%)였다. 방사선폐렴은 종양에 대해 동심성이 30예(81%)로 편심성 7예(19%)에 비해 많이 발생하였다. 방사선폐렴이 발생한 최소 방사선량은 13~38 Gy(평균 21 Gy)였다. 방사선섬유증은 변형된 고식적 형태의 섬유화가 17예(65%)로 가장 많이 발생하였고, 종양 유사 섬유화와 반흔 유사 섬유화가 각각 7예(27%), 2예(8%)에서 관찰되었다. 결론: 사이버나이프 방사선수술 후 방사선폐렴은 종양 주위에서 동심성으로 많이 발생하였다. 방사선섬유증 중 종양 유사 형태의 섬유화는 때때로 재발성 종양과 감별이 어려우므로 방사선 폐손상의 CT 소견에 대해 아는 것이 재발성 종양과 방사선 폐손상을 감별하는 데 도움이 될 수 있다.

흰쥐 장에서 Cis-Diammine Dichloro Platinum(Ⅱ)의 방사선손상에 대한 효과

이경자,이정식 梨花女子大學校 醫科大學 醫科學硏究所 1995 EMJ (Ewha medical journal) Vol.18 No.4

목적 : 흰쥐의 복부에 방사선조사와 cis-DDP를 투여하여 소장과 대장의 조직학적 소견을 토대로 하여 cis-DDP가 장관에서 방사선손상에 미치는 영향을 관찰 한다. 방법 : 흰쥐의 복부에 방사선조사군(6~10 Gy), cia-DDP(2.5mg/kg)투여군, 방사선조사와 cis-DDP 병행군으로 분류하였다. 방사선조사군은 전복부에 선형가속기를 이용하여 단일조사하고 cis-DDP투여군은 복강내 1회 주입하였다. 병행군은 방사선조사 전 30분에 cis-DDP투여군과 방사선조사 직후 cis-DDP투여군으로 분류하며 cis-DDP는복강내 주입하였다 실험완료 후 30일에 동물은 개복하여소장과 대장의 조직학적 소견을 광학현미경과 전자현미경으로 비교 관찰하였다. 결과 : 소장에서 cis-DDP단독군은 점막에 경도의 염증세포침윤과 국소적인 괴사가 관찰되었다. 방사선조사 단독군에서 점막의 괴사는 8 Gy, 방사선 조사와 cia-DDP병행군의 6 Gy에서 관찰되었다. 점막하조직의 섬유화는 방사선조사 단독군은 10 Gy, 방사선조사 전 cis-DDP 투여군은8 Gy, 방사선조사 후 cis-DDP 투여군은 6 Gy에서 나타나기 시작하였으며 근층의 괴사는 3군 모두 8 Gy에서 관찰되었다 소장에서 점막하조직의 섬유화를 정량적 종말점으로 하여 증강율은 방사선조사 전 cis-DDP투여군은1.67, 방사선조사 후 cis-DDP 투여군은 1.25이었다 대장에서 점막하조직의 섬유화는 방사선조사 단독군과 방사선조사 후 cis-DDP투여군의 8 Gy에서 관찰되었으며 방사선조사 전 cis-DDP투여군의 6 Gy에서 관찰되었으며 점막하조직의 섬유화를 정량적 종말점으로 하여 증강율은방사선조사 전 cis-DDP 투여군은 1.33, 방사선조사 후투여군은 1.0이었다. 결론 : 점막하조직의 섬유화를 정량적 종말점으로 하여 증강율이 소장에서 방사선조사 전 cis-DDP투여군은 1.67, 방사선조사 후 cis-DDP투여군은 1.25이었다. 대장에서 증강율은 방사선조사 전 cis-DDP투여군은 1.33, 방사선조사후 cis-DDP투여군은 1.0이었다. Cis-DDP는 소장과 대장에서 방사선의 효과를 증강시키며 특히 cis-DDP를 방사선조사 전에 투여한 경우 방사선손상이 증가되었다. 0bjective : This experimental study was performed for evaluate the effects of cis-di-amminedichloroplatinum(Ⅱ) (cis-DDP) on the radiation injury of rat bowel by histopathologic changes. Method and materials : Rats were exposed to entire abdomen by a single doses of X-ray(6-10 Gy) without or witn cis-DDP(2.5mg/kg). Rats were divided into 3 groups such as radiationalone, cis-DDP alone and combined group. In combined group, cis-DDP was given 30minutes before or immediately after irradiation. Results : Cis-DDP induced the inflammatory cell infiltrations with focal necrosis of the mucosa in the small bowel and no abnormal change in the large bowel. In radiation alone group,mucosal necrosis, subrnucosal fibrosis and muscular necrosis were prominent changes in smallbowel and submucosal fibrosis in the large bowel. The submucosal fibrosis in the small bowelwas appealed in 10 Gy of radiation alone group and 8 Gy of cis-DDP infusion after radiationand 6 Gy of cis-DDP infusion before radiation of combined group. In the large bowel, submucosal fibrosis was noted in 8 Gy of radiation alone group and 8 Gy of cis-DDP infusion after radiation and 6 Gy of cis-DDP infusion before radiation of combined group. In the smallbowel, the enhancement ratio was 1.67 in a group of cis-DDP infusion before radiation and 125 in a group of cis-DDP infusion after radiation as the end point was the submucosal fibrosis,In the large bowel, the enhancement ratio was 1.33 in a group of cis-DDP infusion before radiation and 1.0 in a cup of cis-DDP infusion after radiation as e end point was e submucosal fibrosis. Conclusion : This study suggested that cis-DDP enhance the radiation effect in the small andlarge bowel especially when cis-DDP was infused before radiation.