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Health Effects of Onboard Radiation Accidents in the Soviet Nuclear Submarines 苏联核潜艇艇上辐射事故对健康的影响
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-42-48
L.A. Ilyin, O.A. Kochetkov, A.V. Barabanova, V. Barchukov
Purpose: To analyze the health effects of onboard radiation accidents in the Soviet nuclear submarines. Results: Over the entire operation period of Soviet nuclear submarines, eight severe accidents occurred related to nuclear power installations. These accidents occurred in a confined space and the associated radiation situation is more complex than in other conditions; therefore, health effects of such accidents are more significant. There were two types of onboard accidents: thermal accidents (five cases) associated with a failure during heat removal from the reactor core; and accidents (three cases) caused by a partial chain reaction. The first type of accidents occurred during the route operation of nuclear submarine, and the second one – during repair work. Thermal accidents were associated with varying degrees of depressurization of the primary circuit of the reactor, which increased the gamma and beta background due to the entry into the compartment of a large amount of radioactive noble gases (hereinafter – RBGs) and radioactive aerosols. It has been shown that in the confined space of nuclear submarines, RBG isotopes (mainly 85Кr, 133Хе, 135Хе) make a significant contribution to the individual dose and the skin is a critical organ. Conclusion: An analysis of the health effects of thermal onboard accidents showed that radiation injuries were caused by external gamma- and beta-exposure, as well as the ingestion of radioactive aerosols. If accidents are accompanied by prolonged minor leaks leading to entry of RBG into the compartment, the main contribution is made by beta-exposure and the skin is a critical organ. If there is a simultaneous inflow of coolant into the compartment, combined radiation injuries are formed and, in this case, skin lesions aggravate the acute radiation sickness. In accidents induced by a partial chain reaction, the main radiation factor is external γ-n-exposure during an outbreak of a partial chain reaction, and in the case of a thermal explosion, a traumatic factor also affects a person, leading to injuries of varying severity in the victims.
目的:分析苏联核潜艇艇上辐射事故对健康的影响。结果:苏联核潜艇在整个服役期间共发生8起与核动力装置有关的重大事故。这些事故发生在密闭空间内,相关的辐射情况比其他情况下更为复杂;因此,此类事故对健康的影响更为显著。船上事故有两种类型:热事故(5例)与反应堆堆芯散热过程中的故障有关;以及由部分连锁反应引起的事故(三起)。第一类事故发生在核潜艇的航线作业中,第二类事故发生在核潜艇的维修工作中。热事故与反应堆一次回路的不同程度的降压有关,由于大量放射性惰性气体(以下简称rbg)和放射性气溶胶进入舱室,从而增加了γ和β本底。研究表明,在核潜艇的密闭空间中,RBG同位素(主要是85Кr、133Хе、135Хе)对个体剂量的贡献很大,皮肤是一个关键器官。结论:对船上热事故对健康影响的分析表明,辐射损伤是由外部γ和β暴露以及摄入放射性气溶胶引起的。如果事故伴随着导致RBG进入隔室的长时间轻微泄漏,则主要贡献是β暴露,皮肤是一个关键器官。如果同时有冷却剂流入舱室,就会形成联合辐射损伤,在这种情况下,皮肤损伤会加重急性放射病。在部分链式反应引起的事故中,主要的辐射因素是部分链式反应爆发时的外部γ-n暴露,而在热爆炸的情况下,创伤因素也会影响到人,导致受害者受到不同程度的伤害。
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引用次数: 0
Effect of Radiation and Non-Radiation Factors on the ТBX21 Concentration in lysates of the Mitogen-Stimulated Mononuclear Cells 辐射和非辐射因素对有丝分裂原刺激的单核细胞裂解物中 ТBX21 浓度的影响
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-55-59
E. Kodintseva, AA Akleyev
Purpose: To evaluate the effect of radiation and non-radiation factors on the intracellular concentration of the ТBX21 transcription factor in peripheral blood PHA-stimulated mononuclear cells of chronically exposed residents of the Techa Riverside settlements in the long-term period after the start of exposure. Material and methods: The main group consisted of 30 people aged 67–80 years with the mean dose to the red bone marrow 867±136 mGy, to thymus and peripheral lymphoid organs 125±20 mGy. The comparison group included 10 unexposed people aged 63–82 years. The main and the comparison groups had similar sex and ethnic composition. Peripheral blood mononuclear cells were PHA-stimulated for 24 hours. Cellular lysates were normalized by total protein concentration prior to being used for ELISA test. Results: After 24 hours of incubation the median and interquartile range of the intracellular TBX21 concentration in mononuclear cells was 34.2 (6.6–86.0) pg/ml after the mitogen stimulation, and 0 (0–24.9) pg/ml – without mitogen stimulation (р=0.001). In the comparison group these values made up 24.8 (0.2–47.6) and 13.0 (0–19.2) pg/ml, respectively Conclusion: The intracellular TBX21 concentration after 24-hour mitogen stimulation did not differ statistically significantly in chronically exposed and unexposed people, as well as in people from different dose groups. Statistically significant increase in TBX21 concentration in the lysates of mononuclear cells that were PHA-stimulated for 24 hours relative to non-mitogen stimulated cells was noted in chronically exposed people with medium and high doses to the red bone marrow. No correlation was revealed between the TBX21 concentration and dose characteristics, sex, and ethnicity of the studied individuals. The results are preliminary.
目的:评价辐射和非辐射因素对长期暴露后Techa Riverside定居点居民外周血pha刺激单核细胞ТBX21转录因子浓度的影响。材料与方法:主要组患者30例,年龄67 ~ 80岁,红骨髓平均剂量867±136 mGy,胸腺及周围淋巴器官平均剂量125±20 mGy。对照组包括10名年龄在63-82岁之间的未接触者。主要组和比较组的性别和种族组成相似。外周血单个核细胞被pha刺激24小时。细胞裂解液经总蛋白浓度归一化后用于ELISA检测。结果:孵育24 h后,单核细胞内TBX21浓度中位数和四分位数范围分别为:有丝分裂原刺激后的34.2 (6.6 ~ 86.0)pg/ml,未有丝分裂原刺激时的0 (0 ~ 24.9)pg/ml (χ =0.001)。对照组分别为24.8 (0.2 ~ 47.6)pg/ml和13.0 (0 ~ 19.2)pg/ml。结论:长期接触者和未接触者以及不同剂量组的TBX21细胞内浓度在24小时有丝分裂原刺激后无统计学差异。在长期中、高剂量接触红骨髓的人群中,受pha刺激24小时的单核细胞的溶出物中TBX21的浓度显著高于未受丝裂原刺激的细胞。TBX21浓度与研究个体的剂量特征、性别和种族之间没有相关性。结果是初步的。
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引用次数: 0
Effective Doses of Children During X-Ray Diagnostic Examinations: A Literary Review 儿童在 X 射线诊断检查中的有效剂量:文学评论
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-27-41
I. Shatskiy, P. Druzhinina, Y. Kapyrina, M.V. Osipov
Radiation diagnostics methods are widely used not only for the diagnosis of adult patients, but also in pediatrics. Children are the most radiosensitive group of the population, with a higher risk of developing long-term effects of ionizing radiation than adults. Therefore, control of exposure levels of pediatric patients is a priority. Nowadays, many publications have been devoted to the issues of radiation safety of children in foreign countries. There is no reliable information of diagnostic exposure levels of children in the Russian Federation. In domestic publications, these issues are considered insufficiently. Foreign and domestic publications of children exposure levels during X-ray, interventional and computed tomography examinations (CT-examinations) were analyzed. First of all, publications containing a quantitative characteristic of exposure levels in terms of effective dose (ED) were considered. Effective doses presented in the publications were recalculated in accordance with the division of age groups adopted in the Russian Federation for the convenience of comparing the values with each other: 0‒0.5; 0.5‒3; 3‒8; 8‒13; 13–18 years old. This study presents the average of weighted effective doses for children of all age groups for different types of radiography, interventional and CT-examinations. According to publications the average weighted effective doses of children on average for all types of X-ray diagnostics are lower in the Russian Federation than in foreign countries. To ensure the radiation protection of children in the Russian Federation during radiography, interventional and CT-examinations, it is necessary to increase the reliability of information of children exposure levels, by improving the systems for collecting data, monitoring and accounting of individual patient doses, and raising the level of awareness of specialists.
放射诊断方法不仅广泛应用于成人患者的诊断,也广泛应用于儿科。儿童是人口中对辐射最敏感的群体,与成年人相比,他们受到电离辐射长期影响的风险更高。因此,控制儿科患者的暴露水平是当务之急。如今,许多出版物都致力于国外儿童的辐射安全问题。没有关于俄罗斯联邦儿童诊断性接触水平的可靠信息。在国内出版物中,这些问题被认为不够充分。分析了国内外关于儿童x线、介入性和ct检查中暴露水平的文献。首先,考虑了以有效剂量(ED)表示的含有暴露水平定量特征的出版物。出版物中提出的有效剂量按照俄罗斯联邦采用的年龄组划分重新计算,以便相互比较:0-0.5;0.5 - 3;3 - 8;8日至13日;13-18岁。本研究展示了所有年龄组儿童接受不同类型的放射照相、介入性检查和ct检查时加权有效剂量的平均值。根据出版物,俄罗斯联邦儿童接受各类x射线诊断的平均加权有效剂量低于外国。为了确保俄罗斯联邦儿童在放射照相、介入检查和ct检查期间受到辐射保护,必须通过改进收集数据、监测和核算个别患者剂量的系统以及提高专家的认识水平来提高儿童暴露水平信息的可靠性。
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引用次数: 0
Unified Information System of The Urcrm of Fmba of Russia 俄罗斯 Fmba Urcrm 统一信息系统
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-13-19
V.S. Nikiforov, V.A. Krivoshchapov, N.V. Startsev
A great amount of scientific information on the effect of radiation on the human body in various fields of knowledge from genetics and molecular biology to radiation epidemiology has been accumulated over a long-term period of activity of the URCRM of the FMBA of Russia. To get the best out of the use of numerous registers and databases maintained in the URCRM and to make interdisciplinary research possible, a Unified Information System was created, which consists of two parts: information complex REGISTR and complex Storage. The creation of the Storage complex makes it possible to ensure the safety of scientific data obtained in the departments of the URCRM, as well as methods/techniques elaborated to obtain them. The development of the REGISTR complex, the creation of new functionality in it, have significantly increased the use of information resources, which allows for strategic planning of new research. The paper describes in detail the basic functionality of the Unified Information System. The technical aspect of the usage of the REGISTR complex is presented. An example of the use of the Selections Constructor for planning of the study performed in the Laboratory of Molecular and Cellular Radiobiology of the URCRM of the FMBA of Russia is given. Keywords: unified information system, the Register complex, the Storage complex, personal data protection, prospects for the development of the REGISTER complex For citation: Nikiforov VS, Krivoshchapov VA, Startsev NV. Unified Information System of The Urcrm of Fmba of Russia. Medical Radiology and Radiation Safety. 2023;68(6):13–19. (In Russian). DOI:10.33266/1024-6177-2023-68-6-13-19
从遗传学和分子生物学到辐射流行病学的各个知识领域,关于辐射对人体影响的大量科学信息已经在俄罗斯联邦工商管理学院URCRM的长期活动中积累起来。为了充分利用URCRM中保存的众多注册表和数据库,并使跨学科研究成为可能,创建了一个统一信息系统,该系统由两部分组成:信息复杂的注册表和复杂的存储。存储综合体的建立可以确保URCRM各部门获得的科学数据的安全,以及为获得这些数据而制定的方法/技术的安全。登记册综合设施的发展和其中新功能的创造大大增加了对信息资源的利用,从而可以对新的研究进行战略规划。本文详细介绍了统一信息系统的基本功能。介绍了使用REGISTR复合体的技术方面。本文给出了在俄罗斯联邦工商管理学院(FMBA)分子和细胞放射生物学实验室中使用选择构造器进行研究规划的一个例子。关键词:统一信息系统,注册综合体,存储综合体,个人数据保护,注册综合体发展前景。引文:Nikiforov VS, Krivoshchapov VA, Startsev NV.俄罗斯联邦工商管理学院统一信息系统。医学放射学与辐射安全[j] .放射科学与技术,2013;68(6):13-19。(俄罗斯)。DOI: 10.33266 / 1024-6177-2023-68-6-13-19
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引用次数: 0
Analysis of Vβ-Segment Diversity of T-Cell Receptor in Residents of the Techa Riverside Villages Chronically Exposed to Radiation in the Long-Term Period 长期暴露于辐射的特查河畔村居民的 T 细胞受体 Vβ 段多样性分析
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-49-54
A. Kotikova, E. Blinova, A. Akleyev
Purpose: Study the repertoire of the T-cell receptor in persons chronically exposed to radiation in the long-term period. Material and methods: The study involved 48 people, who were divided into two groups: a group of exposed persons – 31 individuals with the average accumulated dose to red bone marrow (RBM) of 981±130 mGy, and a comparison group – 17 individuals, the average accumulated dose to RBM was 25.3±5.91 mGy. The study groups did not differ significantly in age, gender and ethnicity. The repertoire of Vβ-segments of the T-cell receptor of the peripheral blood T-lymphocytes of exposed persons was analyzed by flow cytometry method. 24 Vβ-segments of the T-cell receptor were studied. Statistical processing of the obtained data was carried out using the Wilcoxon signed-rank test, and a direct description of Vβ-segment repertoire of the T-cell receptor was performed using the Lorenz curve and the Gini-TCR index. Results: The study revealed a statistically significant increase in the number of Vβ3 and Vβ5.2 T-cell receptor segments in exposed individuals relative to the comparison group (p=0.03 and p=0.003, respectively). It was also shown that the distribution of the Vβ-segments of the T-cell receptor is uneven in both study groups. However, there was no significant difference between the repertoires of the T-cell receptor of the studied groups by the Gini-TCR index (p=0.14).
目的:研究长期慢性辐射暴露人群的t细胞受体库。材料与方法:48人被分为两组:受照组31人,平均红骨髓累积剂量为981±130 mGy;对照组17人,平均红骨髓累积剂量为25.3±5.91 mGy。研究小组在年龄、性别和种族方面没有显著差异。用流式细胞术分析暴露者外周血t淋巴细胞v β受体片段库。研究了t细胞受体的24个v β片段。使用Wilcoxon符号秩检验对所得数据进行统计处理,并使用Lorenz曲线和Gini-TCR指数对t细胞受体的v β片段库进行直接描述。结果:与对照组相比,暴露个体的Vβ3和Vβ5.2 t细胞受体片段数量有统计学意义的增加(p=0.03和p=0.003)。研究还表明,在两个研究组中,t细胞受体的v β片段的分布是不均匀的。然而,通过基尼- tcr指数,实验组之间t细胞受体的曲目没有显着差异(p=0.14)。
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引用次数: 0
Brachytherapy of Malignant Neoplasms of the Cervix Uteri: Current Status of the Problem (Literature Review) 子宫颈恶性肿瘤近距离放射治疗:问题的现状(文献综述)
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-99-105
A.A. Zavyalov, A.N. Solodova, A.I. Tyryshkin, E.V. Kryakvina
Purpose: To conduct a search and generalization of literature data to assess the relevance and prospects for the development of brachytherapy in the treatment of cervical cancer. Material and methods: Scientific sources were searched in PubMed / Medline for the following key words: «cervical cancer», «radiotherapy», «brachytherapy». The time horizon covered 2016–2023. Using a time filter, the most relevant and innovative research papers on cervical cancer brachytherapy were selected. Results: Modern radiology provides specialists with a wide range of methods, one of which is brachytherapy (BT). Brachytherapy is a promising direction in the treatment of cervical cancer, however, its use is largely limited and continues to gradually progressively decline around the world. The reasons associated with this are different: the complex technical component of this technique, the high requirements for the training of BT specialists, the high cost of treatment, and others. However, it should be noted that most of the current data demonstrate the high efficacy of BT in the complex therapy of cervical cancer. Therefore, research is ongoing to increase the involvement of BT in the treatment strategy for cervical cancer. Thus, many authors emphasize that the rates of primary complete remission and 5-year cancer-specific survival were significantly higher in patients treated with BT than in those who were treated with EBRT instead of BT (92.5 % versus 73.3 % and 68. 5 % versus 35.4 % respectively). Modern technical developments in the field of BT are also interesting, for example, the use of 3D printing methods. New applicators make it possible to increase the conformity of the conducted BT. The presented methodology also provides an opportunity for better training of specialists in the field of BT. An important aspect of the spread of BT and radiological treatment in general, and along with it the dynamics of the main indicators of survival, is still the socioeconomic factor. Thus, there are direct correlations between the total income of a country and the degree of prevalence of BT in it. Some countries are almost completely deprived of the possibility of using BT methods in health care. In general, brachytherapy is actively developing, opening up new horizons in the treatment of malignant neoplasms of cervical cancer.
目的:对文献资料进行检索和归纳,评价近距离放疗在宫颈癌治疗中的相关性和发展前景。材料和方法:科学来源在PubMed / Medline检索以下关键词:«子宫颈癌»,«放射治疗»,«近距离放射治疗»。时间范围为2016-2023年。采用时间滤波方法,筛选出与宫颈癌近距离治疗相关、最具创新性的研究论文。结果:现代放射学为专家提供了广泛的治疗方法,其中之一是近距离放射治疗(BT)。近距离放射疗法是治疗宫颈癌的一个很有前途的方向,然而,它的使用在很大程度上是有限的,并且在世界范围内继续逐渐减少。与此相关的原因各不相同:该技术的复杂技术组成部分,对BT专家培训的高要求,治疗费用高等等。但值得注意的是,目前的大部分资料都显示了BT在宫颈癌复合治疗中的高疗效。因此,研究正在进行中,以增加BT在宫颈癌治疗策略中的参与。因此,许多作者强调,接受BT治疗的患者的原发性完全缓解率和5年癌症特异性生存率明显高于接受EBRT而不是BT治疗的患者(92.5%对73.3%和68%)。分别为5%和35.4%)。BT领域的现代技术发展也很有趣,例如3D打印方法的使用。新的应用程序可以提高所进行的BT的一致性。所提出的方法也为更好地培训BT领域的专家提供了机会。BT和放射治疗的传播的一个重要方面,以及随之而来的主要生存指标的动态,仍然是社会经济因素。因此,一个国家的总收入与其BT的流行程度之间存在着直接的相关性。一些国家几乎完全丧失了在卫生保健中使用BT方法的可能性。总的来说,近距离放疗正在积极发展,为宫颈癌恶性肿瘤的治疗开辟了新的视野。
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引用次数: 0
Comparison of Photon and Neutron Radiation Dosimetric Systems Used in Organizations of Rosatom State Corporation for Control in A Planned Exposure Situation 俄罗斯国家原子能公司(Rosatom State Corporation)各机构为控制计划暴露情况而使用的光子和中子辐射剂量测量系统的比较
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-118-124
O.A. Kochetkov, E.Yu. Tarasova, S.M. Shinkarev, E.A. Rumyantsev
Purpose: Using the example of reviewing and discussing the results of comparison tests of dosimetric systems of gamma and neutron radiation used in organizations of the State Corporation “Rosatom”, to assess the current state of reliability of monitoring the planned exposure of workers in fields of mixed gamma-neutron radiation using the considered dosimetric systems in order to produce recommendations for corrective actions to ensure a unified approach to conduct individual dosimetric control of external exposure. Results: All measuring instruments for individual dose equivalent of photon and neutron radiation, presented in comparison tests, comply with up-to-date requirements for individual dosimetric control systems. All measuring instruments confirmed their measuring capabilities, showed satisfactory quality of measurement results and the absence of a systematic bias in the measurement results. Analysis of the results of measuring the individual dose equivalent of neutron radiation showed that problems affecting the quality of the results obtained were identified in the considered instruments of measuring personal dose equivalent. The following factors might be the sources of problems: lack of knowledge about the real characteristics of radiation fields (spectral characteristics, radiation direction, etc.) at workplaces; insufficient research of the method used for measuring neutron radiation under real conditions (technical and metrological characteristics and features of the individual dosimeters used); failure to take into account the weighing coefficients for neutrons of various energies when measuring instruments are calibrated and when real measurements are conducted. Conclusion: It is necessary to organize and conduct investigations of the metrological characteristics of the measuring instrument that are used under conditions typical for a specific radiation object. After finishing these experimental studies, it is recommended to test the methodology with an analysis of the compliance of the accuracy indicators with the requirements of the relevant guidelines. In order to solve the problem of a lack of knowledge about the real characteristics of radiation fields, radiation safety services of organizations are recommended to organize and conduct research aimed at studying such characteristics using radiometric and spectrometric methods, experimental modeling of the process of personnel exposure using anthropomorphic phantoms and determining correction factors for the individual dosimeters used.
目的:以审查和讨论国家"俄罗斯国家原子能公司"各组织使用的伽马辐射和中子辐射剂量计量系统的比较试验结果为例,评估使用所考虑的剂量学系统监测混合伽马-中子辐射领域工作人员计划照射的可靠性现状,以便提出纠正措施建议,以确保采用统一的方法对外部照射进行个人剂量学控制。结果:在比较试验中,所有的光子和中子辐射的剂量当量测量仪器都符合最新的剂量控制系统的要求。所有测量仪器都确认了它们的测量能力,显示了令人满意的测量结果质量,并且测量结果中没有系统偏差。对测量中子辐射个人剂量当量结果的分析表明,在考虑的测量个人剂量当量的仪器中发现了影响所得结果质量的问题。以下因素可能是问题的根源:对工作场所辐射场的真实特征(光谱特征、辐射方向等)缺乏了解;对实际条件下测量中子辐射的方法研究不足(所使用的个别剂量计的技术和计量特性和特征);在校准测量仪器和进行实际测量时,没有考虑到不同能量的中子的称重系数。结论:有必要对特定辐射对象典型条件下使用的测量仪器的计量特性进行组织和研究。在完成这些实验研究后,建议对方法进行检验,分析准确度指标是否符合相关指南的要求。为了解决人们对辐射场的真实特征缺乏了解的问题,建议各组织的辐射安全服务部门组织开展研究,利用辐射学和光谱学方法研究辐射场的真实特征,利用拟人模型对人员照射过程进行实验建模,并确定所使用的个别剂量计的校正系数。
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引用次数: 0
Comparison of Radiation and Chemical Toxicity of Uranium Compounds on The Basis of Calculation by New Icrp Biokinetic Models 在新的 Icrp 生物动力学模型计算基础上比较铀化合物的辐射毒性和化学毒性
Q4 Medicine Pub Date : 2023-12-01 DOI: 10.33266/1024-6177-2023-68-6-20-26
A.A. Molokanov, N. Potsyapun, E.Yu. Maksimova, Yu. E. Kvacheva
Purpose: Harmonization and improvement of the system for regulating the internal radiation exposure of workers and the basic requirements for ensuring radiation safety, taking into account the application of new international requirements and recommendations. Material and methods: The article presents a comparison of the radiation and chemical toxicity of uranium compounds, obtained on the basis of calculating the levels of inhalation intake and committed effective dose depending on the types of compounds F, M, F/M and M/S in the AMAD range from 0.3 to 20 μm for typical isotopic compositions of natural (NU), depleted (DU), low enriched (LEU) and highly enriched (HEU) uranium, which lead to the maximum permissible concentration of uranium in the kidneys. The calculations were carried out using new ICRP biokinetic models, which give more physiologically realistic representations of uptake and retention in organs and tissues, and excretion. Results: The dynamics of uranium activity in the kidneys was calculated for constant chronic inhalation intake over a 50-year period and for acute intake. It was shown that in case of chronic intake, the rate of accumulation of uranium in the kidneys, expressed in relative units, does not depend on the AMAD in the range from 0.3 to 20 μm and slightly depends on the types of compounds F, F/M, M and M/S, which include almost all chemical compounds of uranium. In case of acute intake, there is a rapid, within 1–3 days, an increase of uranium in the kidneys to a maximum value and then a gradual decrease to a value of 20 % of the maximum value in 20–60 days, depending on the type of compound F, M, F/M, M/S and AMAD in a wide range of values from 0.3 to 20 µm. To compare the radiation and chemical toxicity of uranium, the values of the committed effective dose were calculated, which is formed after intake of uranium aerosols of the types F, M, F/M and M/S and AMADs from 0.3 to 20 µm in an amount that creates the maximum concentration of uranium in the kidneys 0.3 µg/g for chronic intake and 3 µg/g for acute intake. The values of uranium intake per year in milligrams, which form the maximum concentration of uranium in the kidneys of 0.3 µg/g, in case of constant chronic intake of uranium aerosols, as well as the values of uranium intake in milligrams, which form the maximum concentration of uranium in the kidneys of 3 μg/g after a single intake of uranium aerosols in both case of the types F, M, F/M and M/S and AMAD in the range from 0.3 to 20 µm were calculated, which are evidently independent of the considered isotopic composition of the uranium. Conclusion: It is shown that chemical toxicity prevails over radiation toxicity for the types of uranium compounds F and F/M for all considered uranium isotopic composition, except for HEU; for the type of compound M it is the same for mixtures of NU and DU, and for the type M/S radiation toxicity prevails for all considered uranium isotopic composition. In case of chronic in
目的:考虑到新的国际要求和建议的应用,协调和改进管理工人内部辐射照射的制度和确保辐射安全的基本要求。材料和方法:本文根据天然铀(NU)、贫铀(DU)、低浓铀(LEU)和高浓铀(HEU)的典型同位素组成在0.3 ~ 20 μm的AMAD范围内化合物F、M、F/M和M/S的类型,计算吸入摄入量和承诺有效剂量的水平,比较了铀化合物的辐射和化学毒性。这些化合物导致肾脏中铀的最大允许浓度。计算是使用新的ICRP生物动力学模型进行的,该模型提供了器官和组织中摄取和保留以及排泄的更现实的生理表征。结果:计算了50年期间持续慢性吸入和急性吸入的肾脏铀活性动态。结果表明,在慢性摄入的情况下,肾脏中铀的积累速率(以相对单位表示)不依赖于0.3 ~ 20 μm范围内的AMAD,而与化合物F、F/M、M和M/S的类型有轻微的关系,其中包括铀的几乎所有化合物。在急性摄入的情况下,肾脏中的铀在1-3天内迅速增加到最大值,然后在20 - 60天内逐渐减少到最大值的20%,这取决于化合物F, M, F/M, M/S和AMAD的类型,范围从0.3到20µM不等。为了比较铀的辐射和化学毒性,计算了承诺有效剂量值,该剂量是在摄入F、M、F/M和M/S型铀气溶胶和AMADs 0.3 ~ 20 μ M时形成的,其量在肾脏中产生的最大铀浓度为0.3 μ g/g,慢性摄入为0.3 μ g/g,急性摄入为3 μ g/g。铀在毫克,摄入每年的值构成的最大浓度铀0.3µg / g,肾脏的慢性摄入的常数的铀气溶胶,以及铀在毫克,摄入的值构成的最大浓度铀的肾脏后3μg / g单摄入铀气溶胶在两种类型的F, M, F / M和M / S和哈桑的范围从0.3到20µM计算,这显然与铀的同位素组成无关。结论:除高浓铀外,所有铀同位素组成中铀化合物F和F/M类型的化学毒性均大于辐射毒性;对于化合物M类型,NU和DU的混合物的辐射毒性是相同的,对于M/S类型的辐射毒性普遍存在于所有考虑的铀同位素组成中。在以每年数毫西弗的承诺有效剂量暴露率长期摄入铀的情况下,工人在工作1-2年后就可能在接触F和F/M化合物以及天然(NU)、贫(DU)和低浓(LEU)铀的同位素组成时遭受铀的化学毒性。在急性摄入的情况下,应以铀的化学毒性作为化合物F和F/M的限制暴露标准,也应以部分M (NU、DU和LEU的铀同位素组成)作为限制暴露的标准,这可以显着降低铀摄入的允许限度,几十倍甚至上百倍。
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引用次数: 0
Radionuclide Diagnosis of Sentinel Lymph Nodes in Breast cancer with a Radiopharmaceutical Based on Technetium-99m Labeled Gamma Aluminum Oxide 基于锝-99m标记γ氧化铝的放射性药物对乳腺癌前哨淋巴结的放射性核素诊断
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-88-95
A.A. Medvedeva, A.N. Rуbina, R.V. Zeltchan, O.D. Bragina, A.V. Doroshenko, E.Iu. Garbukov, N.A. Tarabanovskaya, L.A. Tashireva, V.I. Chernov
Аim: To analyze the results of radionuclide diagnostics of sentinel lymph nodes (SLN) in patients with breast cancer (BC) with the radiotracer Sentiscan, 99mTc (manufacturer “MedicorPharma-Ural”) using the multimodal SPECT/CT at the stage of visualization. Material and methods: The study was retrospective, it included 48 patients with BC with clinical stage T2-3N0M0, who underwent radionuclide diagnostics of SLN and SPECT/CT was performed at the imaging stage. The images were evaluated visually, the intensity of the radiotracer accumulation in the lymph nodes (LN) was analyzed, SUVmax was used as a quantitative parameter. Intraoperative detection of SLN with subsequent histological examination was also carried out with the calculation of the level of the radiotracer accumulation. Results: On tomoscintigrams, LNs were visualized in 43 patients out of 48, intraoperatively ‒ in 46 cases, in 2 patients, accumulation of the radiotracer in the LN projection was noted neither according to SPECT/CT, nor intraoperatively. When analyzing the intensity of the radiotracer accumulation according to SPECT/CT data, a rather large scatter of SUVmax‒35 [10‒104]. Sentinel were considered LNs with the level of the radiotracer accumulation in them of at least 10 % of the most intense node. According to SPECT/CT data, 165 lymph nodes were identified, the average number of lymph nodes detected in one patient was 2 [1‒3], the maximum number was 6 lymph nodes. In all patients, the lymph nodes were determined in the projection of the 1st level, in 25 cases ‒ in the projection of other zones of regional lymphatic outflow. The total number of lymph nodes removed during surgery was n=247, on average 3 [2‒5] lymph nodes were removed in one patient, with a maximum of 8 nodes. Conclusion: The sensitivity of radionuclide diagnostics of SLN with Sentiscan, 99mTc was 89.6 % according to SPECT/CT and 95.8 % according to the results of intraoperative detection. The use of multimodal imaging provides information on the exact anatomical localization of the lymph nodes. In the absence of scintigraphic visualization of the radiotracer redistribution in the lymphatic collector, intraoperative detection does not lose its relevance.
Аim:分析放射示踪剂Sentiscan, 99mTc(制造商“MedicorPharma-Ural”)在多模态SPECT/CT显像阶段对乳腺癌(BC)患者前哨淋巴结(SLN)的放射性核素诊断结果。材料与方法:本研究为回顾性研究,纳入48例临床分期为T2-3N0M0的BC患者,行放射性核素诊断为SLN,影像学阶段行SPECT/CT检查。视觉评价图像,分析放射性示踪剂在淋巴结(LN)积聚的强度,以SUVmax作为定量参数。术中对SLN进行检测,随后进行组织学检查,并计算放射性示踪剂积累水平。结果:在48例患者的断层显像上,术中有43例患者可见LN,其中46例,2例患者在SPECT/CT检查和术中均未发现LN投影中放射性示踪剂的积累。当根据SPECT/CT数据分析放射性示踪剂积累强度时,SUVmax-35有相当大的散射[10-104]。当放射性示踪剂在前哨淋巴结的积累水平至少达到最强烈淋巴结的10%时,前哨淋巴结被认为是淋巴结。SPECT/CT资料显示165个淋巴结,每例患者平均发现2个淋巴结[1-3],最多发现6个淋巴结。在所有患者中,淋巴结在第一层的投影中确定,在25例中-在区域淋巴流出的其他区域的投影中确定。术中切除淋巴结总数n=247,平均1例患者切除3个[2-5]淋巴结,最多8个。结论:应用Sentiscan, 99mTc对SLN的放射性核素诊断,SPECT/CT的敏感性为89.6%,术中检测的敏感性为95.8%。多模态成像的使用提供了淋巴结精确解剖定位的信息。在没有放射示踪剂在淋巴收集器重新分布的显像显示的情况下,术中检测并不失去其相关性。
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引用次数: 0
Thermoradiochemotherapy in the Combined Treatment of Rectal Cancer 热放化疗在直肠癌综合治疗中的应用
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.33266/1024-6177-2023-68-5-77-81
D.A. Plaskeeva, A.I. Konovalov, Zh.A. Startseva, S.G. Afanasyev
Currently, the treatment of rectal cancer requires a multidisciplinary approach. So the combined method of treatment, including chemoradiotherapy and the surgical stage, has proven itself reliably. However, the desired results that significantly increase the rates of relapse-free and metastatic survival have not yet been achieved. The use of radio modifiers makes it possible to enhance radiation exposure without increasing the total focal dose. One of the universal radio modifiers is local hyperthermia. Purpose: To develop a method of thermoradiochemotherapy in the combined treatment of distal rectal cancer and evaluate its effectiveness. Material and methods: This work is based on the analysis of the results of treatment of 141 patients with morphologically confirmed locally advanced distal rectal cancer. In accordance with the objectives of the study, all patients were divided into 2 groups. In the combined treatment of 75 patients, the first stage was performed chemoradiotherapy (CLT) in combination with local hyperthermia (LH). Local hyperthermia was not used in the treatment of 66 patients. Results: Long-term results of complex treatment of patients with an independent course of chemoradiotherapy/thermochemoradiotherapy (dynamic observation group) and after surgical treatment are presented. One – year relapse-free survival in the group with an independent course of TRHT was 96.7 %, in the CLT group – 79.3 % (p=0.024). There was a significant increase in three–year relapse-free survival – 93.3 % versus 76.7 % in the control (p=0.041). Among patients who underwent surgical treatment at the second stage, the study of one-year relapse-free survival did not reveal statistical significance. Three – year relapse-free survival in patients with TRHT compared with the CLT group was 96.2 % versus 86.0 % (p=0.038). The effectiveness of thermoradiochemotherapy in patients of this category was evaluated. The tolerability of treatment in all patients is satisfactory. Among all radiation reactions, the most frequently observed phenomena of radiation epidermitis I–II art. in the projection of irradiation fields (Table 1). Acute radiation reactions were reversible and did not have a negative effect on the subsequent stages of treatment. Treatment for all patients (n=141) was implemented in full.
目前,直肠癌的治疗需要多学科结合。因此,包括放化疗和手术阶段在内的综合治疗方法已被证明是可靠的。然而,显著提高无复发生存率和转移性生存率的预期结果尚未实现。使用无线电调节剂可以在不增加总焦剂量的情况下增强辐射照射。一种通用的无线电治疗方法是局部热疗。目的:建立一种热放化疗联合治疗远端直肠癌的方法,并评价其疗效。材料和方法:本工作基于141例经形态学证实的局部晚期远端直肠癌的治疗结果分析。根据研究目的,将所有患者分为两组。在75例患者的联合治疗中,第一阶段进行放化疗(CLT)联合局部热疗(LH)。66例患者未采用局部热疗。结果:给出了独立放化疗/热放化疗疗程(动态观察组)患者及术后综合治疗的远期结果。TRHT独立疗程组的1年无复发生存率为96.7%,CLT组为79.3% (p=0.024)。3年无复发生存率显著增加,为93.3%,对照组为76.7% (p=0.041)。在二期手术治疗的患者中,1年无复发生存率的研究无统计学意义。TRHT组与CLT组的3年无复发生存率分别为96.2%和86.0% (p=0.038)。对该类患者进行热放化疗的效果进行评价。所有患者对治疗的耐受性均令人满意。在所有的辐射反应中,最常见的是放射性表皮炎。(表1)。急性辐射反应是可逆的,对后续治疗阶段没有负面影响。所有患者(n=141)均得到全面治疗。
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Medical Radiology and Radiation Safety
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