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Younes HM, Kadavil H, Ismail HM, Adib SA, Zamani S, Alany RG, Al-Kinani AA. Overview of Tissue Engineering and Drug Delivery Applications of Reactive Electrospinning and Crosslinking Techniques of Polymeric Nanofibers with Highlights on Their Biocompatibility Testing and Regulatory Aspects. Pharmaceutics 2023; 16:32. [PMID: 38258043 PMCID: PMC10818558 DOI: 10.3390/pharmaceutics16010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
Traditional electrospinning is a promising technique for fabricating nanofibers for tissue engineering and drug delivery applications. The method is highly efficient in producing nanofibers with morphology and porosity similar to the extracellular matrix. Nonetheless, and in many instances, the process has faced several limitations, including weak mechanical strength, large diameter distributions, and scaling-up difficulties of its fabricated electrospun nanofibers. The constraints of the polymer solution's intrinsic properties are primarily responsible for these limitations. Reactive electrospinning constitutes a novel and modified electrospinning techniques developed to overcome those challenges and improve the properties of the fabricated fibers intended for various biomedical applications. This review mainly addresses reactive electrospinning techniques, a relatively new approach for making in situ or post-crosslinked nanofibers. It provides an overview of and discusses the recent literature about chemical and photoreactive electrospinning, their various techniques, their biomedical applications, and FDA regulatory aspects related to their approval and marketing. Another aspect highlighted in this review is the use of crosslinking and reactive electrospinning techniques to enhance the fabricated nanofibers' physicochemical and mechanical properties and make them more biocompatible and tailored for advanced intelligent drug delivery and tissue engineering applications.
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Affiliation(s)
- Husam M. Younes
- Tissue Engineering & Nanopharmaceuticals Research Laboratory (TENRL), Office of Vice President for Research & Graduate Studies, Qatar University, Doha P.O. Box 2713, Qatar; (H.K.); (H.M.I.); (S.A.A.)
| | - Hana Kadavil
- Tissue Engineering & Nanopharmaceuticals Research Laboratory (TENRL), Office of Vice President for Research & Graduate Studies, Qatar University, Doha P.O. Box 2713, Qatar; (H.K.); (H.M.I.); (S.A.A.)
| | - Hesham M. Ismail
- Tissue Engineering & Nanopharmaceuticals Research Laboratory (TENRL), Office of Vice President for Research & Graduate Studies, Qatar University, Doha P.O. Box 2713, Qatar; (H.K.); (H.M.I.); (S.A.A.)
- Charles River Laboratories, Montreal, QC H9X 3R3, Canada
| | - Sandi Ali Adib
- Tissue Engineering & Nanopharmaceuticals Research Laboratory (TENRL), Office of Vice President for Research & Graduate Studies, Qatar University, Doha P.O. Box 2713, Qatar; (H.K.); (H.M.I.); (S.A.A.)
| | - Somayeh Zamani
- Tissue Engineering & Nanopharmaceuticals Research Laboratory (TENRL), Office of Vice President for Research & Graduate Studies, Qatar University, Doha P.O. Box 2713, Qatar; (H.K.); (H.M.I.); (S.A.A.)
- Materials Science & Engineering, Cornell University, Ithaca, NY 14853, USA
| | - Raid G. Alany
- School of Pharmacy, The University of Auckland, Auckland 1142, New Zealand; (R.G.A.); (A.A.A.-K.)
- Drug Discovery, Delivery and Patient Care (DDDPC) Theme, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, London KT2 7LB, UK
| | - Ali A. Al-Kinani
- School of Pharmacy, The University of Auckland, Auckland 1142, New Zealand; (R.G.A.); (A.A.A.-K.)
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Alzyoud K, Al-Murshedi S, England A. Effective dose and image quality for different patient sizes during AP upper abdominal radiography: A phantom study. Appl Radiat Isot 2023; 202:111060. [PMID: 37806283 DOI: 10.1016/j.apradiso.2023.111060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 09/17/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Undertaking medical imaging examinations on obese patients can present practical challenges. Choosing optimal imaging protocols can be difficult, especially when promoting the ALARA principle. The aim of this study was to assess the effects of increasing body part thickness on image quality (IQ) and effective dose (ED) during upper abdominal radiography. A secondary aim was to determine the optimum exposure settings for larger sized patients. METHODS Underweight, standard, overweight and obese abdomen sizes were simulated using an anthropomorphic upper abdomen phantom, without and with additional fat layers (6, 10 and 16 cm). Phantoms were imaged using a variety of tube potentials (70-110 kVp), automatic exposure control (AEC) and a source-to-image distance of 120 cm. IQ was assessed visually using a relative visual grading analysis (VGA) method. Radiation dose was evaluated by calculating the ED using the Monte Carlo PCXMC 2.0 computer program. RESULTS IQ values showed a statistical reduction (p = 0.006) with increasing phantom size across all examined tube potentials. The highest IQ scores (3.3, 2.8, 2.5 and 2.2, respectively) were obtained at 70/75 kVp for all phantom thicknesses. As tube potential increased the IQ was also shown to decrease. ED showed a statistically significant increase (p < 0.001) with increasing phantom thicknesses. CONCLUSION Higher EDs were evident when applying lower tube potentials. Using an AEC with high tube potentials (105/110 kVp) can lead to a considerable decrease in ED with acceptable IQ when undertaking upper abdomen radiography on patients with large body part thicknesses. IMPLICATION FOR PRACTICE Applying higher values of tube potentials for patients who have a thicker abdomen can lead to decreased ED.
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Affiliation(s)
- Kholoud Alzyoud
- Department of Medical Imaging, Faculty of Applied Health Science, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan.
| | - Sadeq Al-Murshedi
- AL-Zahraa University for Women, College of Health and Medical Technology, Karbala, Iraq
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Lander S, Obudzinski S, Michels J, Brayer A, D'amore T, Chess M, Cook CP, Wakeman D, Sanders J. Safely Reducing Unnecessary Radiographs in Suspected Pediatric Musculoskeletal Injuries: A Multidisciplinary Developed Algorithm. Pediatr Emerg Care 2023:00006565-990000000-00288. [PMID: 37391193 DOI: 10.1097/pec.0000000000003004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
BACKGROUND While radiographs are a critical component of diagnosing musculoskeletal (MSK) injuries, they are associated with radiation exposure, patient discomfort, and financial costs. Our study initiative was to develop a system to diagnose pediatric MSK injuries efficiently while minimizing unnecessary radiographs. METHODS This was a quality improvement trial performed prospectively at a single level one trauma center. A multidisciplinary team with leaders from pediatric orthopedics, trauma surgery, emergency medicine, and radiology created an algorithm delineating which x-rays should be obtained for pediatric patients presenting with MSK injuries. The intervention was performed in the following 3 stages: stage 1: retrospective validation of the algorithm, stage 2: implementation of the algorithm, and stage 3: sustainability evaluation. Outcomes measured included number of extra radiographs per pediatric patient and any missed injuries. RESULTS In stage 1, 295 patients presented to the pediatric emergency department with MSK injuries. A total of 2148 radiographs were obtained, with 801 not indicated per the protocol, for an average of 2.75 unnecessary radiographs per patient. No injuries would have been missed using the protocol. In stage 2, 472 patients had 2393 radiographs with 339 not indicated per protocol, averaging 0.72 unnecessary radiographs per patient, a significant reduction from stage 1 (P < 0.001). There were no missed injuries identified on follow-up. In stage 3, improvement was sustained for the subsequent 8 months with an average of 0.34 unnecessary radiographs per patient (P < 0.05). CONCLUSIONS Sustained reduction of unnecessary radiation to pediatric patients with suspected MSK injuries was accomplished through the development and implementation of a safe and effective imaging algorithm. The multidisciplinary approach, widespread education of pediatric providers, and standardized order sets improved buy-in and is generalizable to other institutions.Level of Evidence: III.
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Affiliation(s)
- Sarah Lander
- From the Department of Orthopedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY
| | | | | | - Anne Brayer
- Department of Pediatric Emergency, University of Rochester Medical Center, Rochester, NY
| | | | | | | | - Derek Wakeman
- Pediatric Surgery, University of Rochester Medical Center, Rochester, NY
| | - James Sanders
- Department of Orthopedics, University of North Carolina, Chapel Hill, NC
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Akh LA, Ishak MO, Harris JF, Glaros TG, Sasiene ZJ, Mach PM, Lilley LM, McBride EM. -Omics potential of in vitro skin models for radiation exposure. Cell Mol Life Sci 2022; 79:390. [PMID: 35776214 PMCID: PMC11073334 DOI: 10.1007/s00018-022-04394-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/12/2022] [Accepted: 05/24/2022] [Indexed: 11/12/2022]
Abstract
There is a growing need to uncover biomarkers of ionizing radiation exposure that leads to a better understanding of how exposures take place, including dose type, rate, and time since exposure. As one of the first organs to be exposed to external sources of ionizing radiation, skin is uniquely positioned in terms of model systems for radiation exposure study. The simultaneous evolution of both MS-based -omics studies, as well as in vitro 3D skin models, has created the ability to develop a far more holistic understanding of how ionizing radiation affects the many interconnected biomolecular processes that occur in human skin. However, there are a limited number of studies describing the biomolecular consequences of low-dose ionizing radiation to the skin. This review will seek to explore the current state-of-the-art technology in terms of in vitro 3D skin models, as well as track the trajectory of MS-based -omics techniques and their application to ionizing radiation research, specifically, the search for biomarkers within the low-dose range.
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Affiliation(s)
- Leyla A Akh
- Biosecurity and Public Health Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM, 87545, USA
| | - Mohammad O Ishak
- Biosecurity and Public Health Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM, 87545, USA
| | - Jennifer F Harris
- Biosecurity and Public Health Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM, 87545, USA
| | - Trevor G Glaros
- Bioenergy and Biome Sciences Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM, 87545, USA
| | - Zachary J Sasiene
- Bioenergy and Biome Sciences Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM, 87545, USA
| | - Phillip M Mach
- Bioenergy and Biome Sciences Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM, 87545, USA
| | - Laura M Lilley
- Physical Chemistry and Applied Spectroscopy Group, Chemistry Division, Los Alamos National Laboratory, Los Alamos, NM, 87545, USA.
| | - Ethan M McBride
- Bioenergy and Biome Sciences Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM, 87545, USA.
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Sadeghinezhad S, Khodamoradi E, Diojan L, Taeb S, Najafi M. Radioprotective Mechanisms of Arbutin: A Systematic Review. Curr Drug Res Rev 2022; 14:132-138. [PMID: 35319405 DOI: 10.2174/2589977514666220321114415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/15/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE Efforts to produce radioprotective agents of high potential are appropriate strategies for overcoming possible IR toxicity in organisms. The present research aims to evaluate the signaling pathways and mechanisms through which arbutin exerts radioprotective effects on organisms. METHODS The databases of PubMed, Web of Sciences, Google Scholar, and Scopus were searched to find studies that reported radioprotective effects for arbutin. Besides, the data were searched within the time period from 2010 to 2020. RESULTS Five research articles met our criteria, which were included in the analysis based on their relevance to the topic. The present systematic review provides conclusions about various mechanisms and pathways through which arbutin induces radioprotection. CONCLUSIONS Based on the relevant studies, various mechanisms can be proposed for inducing radioprotective effects by arbutin, including inhibition of oxidative stress, apoptosis, and inflammation.
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Affiliation(s)
- Shima Sadeghinezhad
- Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Khodamoradi
- Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Loghman Diojan
- Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Taeb
- Department of Radiology, School of Paramedicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Masoud Najafi
- Medical Technology Research Center, Institute of Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Doruyter AGG, Holness JL. Dual energy window imaging for optimisation of P/V ratios in VP SPECT. EJNMMI Phys 2021; 8:69. [PMID: 34655369 PMCID: PMC8520548 DOI: 10.1186/s40658-021-00417-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 10/01/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose Ventilation–perfusion single-photon emission computed tomography (VP SPECT) plays an important role in pulmonary embolism diagnosis. Rapid results may be obtained using same-day ventilation followed by perfusion imaging, but generally requires careful attention to achieving an optimal count rate ratio (P/V ratio) of ≥ 3:1. This study investigated whether the ratio of counts simultaneously acquired in adjacent primary and Compton scatter energy windows (Eratio) on V SPECT was predictive of final normalised perfusion count rate (PCRnorm) on P SPECT using [99mTc]Tc-macroaggregated albumin (MAA), thus allowing for optimisation of P/V ratios. Methods Same-day VP SPECT studies acquired using standard protocols in adult patients during a 2-year period (training dataset) were assessed. Studies were included provided they were acquired with correct imaging parameters, and injection site imaging and laboratory records were available for quality control and normalised count rate corrections. Extraction of DICOM information, and linear regression were performed using custom Python and R scripts. A predictive tool was developed in Microsoft Excel. This tool was then validated using a second (validation) dataset of same-day studies acquired over a subsequent 7-month period. Accuracy of the prediction tool was assessed by calculating the mean absolute percentage error (MAPE). Results Of 643 studies performed, the scans of 342 participants (median age 30.4 years, 318 female) were included in the training dataset, the analysis of which yielded a significant regression equation (F(1,340) = 1057.3, p < 0.0001), with an adjusted R2 of 0.756 and MSE of 0.001089. A prediction tool designed for routine clinical use was developed for predicting final P/V ratio. Of an additional 285 studies, 198 were included in the second (validation) dataset (median age 29.7 years, 188 female). The Excel-based tool was shown to be 91% accurate (MAPE: 9%) in predicting P/V ratio. Conclusion The relationship between the ratio of simultaneously acquired counts in adjacent energy windows on V SPECT and perfusion count rate after administration of a known activity of [99mTc]Tc-MAA can be linearly approximated. A predictive tool based on this work may assist in optimising the dose and timing of [99mTc]Tc-MAA administration in same-day studies to the benefit of patients and workflows. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-021-00417-z.
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Affiliation(s)
- A G G Doruyter
- NuMeRI Node for Infection Imaging, Central Analytical Facilities, Stellenbosch University, Cape Town, South Africa. .,Division of Nuclear Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - J L Holness
- Nuclear Medicine Division, Department of Radiation Medicine, University of Cape Town, Cape Town, South Africa
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May JM, Bylicky M, Chopra S, Coleman CN, Aryankalayil MJ. Long and short non-coding RNA and radiation response: a review. Transl Res 2021; 233:162-179. [PMID: 33582242 PMCID: PMC8475769 DOI: 10.1016/j.trsl.2021.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/02/2021] [Accepted: 02/07/2021] [Indexed: 12/12/2022]
Abstract
Once thought of as arising from "junk DNA," noncoding RNAs (ncRNAs) have emerged as key molecules in cellular processes and response to stress. From diseases such as cancer, coronary artery disease, and diabetes to the effects of ionizing radiation (IR), ncRNAs play important roles in disease progression and as biomarkers of damage. Noncoding RNAs regulate cellular processes by competitively binding DNA, mRNA, proteins, and other ncRNAs. Through these interactions, specific ncRNAs can modulate the radiosensitivity of cells and serve as diagnostic and prognostic biomarkers of radiation damage, whether from incidental exposure in radiotherapy or in accidental exposure scenarios. Analysis of RNA expression after radiation exposure has shown alterations not only in mRNAs, but also in ncRNAs (primarily miRNA, circRNA, and lncRNA), implying an important role in cellular stress response. Due to their abundance and stability in serum and other biofluids, ncRNAs also have great potential as minimally invasive biomarkers with advantages over current biodosimetry methods. Several studies have examined changes in ncRNA expression profiles in response to IR and other forms of oxidative stress. Furthermore, some studies have reported modulation of radiosensitivity by altering expression levels of these ncRNAs. This review discusses the roles of ncRNAs in the radiation response and evaluates prior research on ncRNAs as biomarkers of radiation damage. Future directions and applications of ncRNAs in radiation research are introduced, including the potential for a clinical ncRNA assay for assessing radiation damage and for the therapeutic use of RNA interference (RNAi).
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Affiliation(s)
- Jared M May
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Michelle Bylicky
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Sunita Chopra
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - C Norman Coleman
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland; Radiation Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Molykutty J Aryankalayil
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.
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Kim SC, Son JS. Double-layered fiber for lightweight flexible clothing providing shielding from low-dose natural radiation. Sci Rep 2021; 11:3676. [PMID: 33574471 PMCID: PMC7878484 DOI: 10.1038/s41598-021-83272-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/27/2021] [Indexed: 11/18/2022] Open
Abstract
Natural and medical radiation are the most frequent sources of daily low-dose radiation exposure for the general public, but these radiation levels are generally acceptable. Among various occupations, aviation crew members and medical workers are exposed to high levels of radiation from scattered rays. This study focused on developing clothing for shielding aviation crew members from natural radiation during air travel. Materials were selected considering their radiation-shielding properties. A tungsten double-layered composite yarn and a polyethylene terephthalate (PET) fiber fabric containing BaSO4 were manufactured. The characteristics and shielding performances of the products were analyzed. Prototypes of a protective scarf (for shielding the thyroid gland) and apron (for shielding the torso) for flight attendants were produced. A lightweight fabric was produced that neither restricts the movement of the wearer nor causes them skin discomfort. The shielding performances of the tungsten composite and PET fiber fabrics containing BaSO4 were 0.018 mmPb and 0.03 mmPb, respectively, demonstrating low-dose shielding that may be useful for protecting aviation crew members from scattered rays. The characteristics of the developed fibers are comparable to those of materials used in clothing production; therefore, low-dose radiation-shielding clothing could be manufactured for use in aviation, medical, and other industries.
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Affiliation(s)
- Seon-Chil Kim
- Department of Biomedical Engineering, Keimyung University School of Medicine, Daegu, Korea.
| | - Jun Sik Son
- Korea Textile Development Institute, Daegu, Korea
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Ulibarri N, Tracy CL, McCarty RJ. Cleanup and Complexity: Nuclear and Industrial Contamination at The Santa Susana Field Laboratory, California. ENVIRONMENTAL MANAGEMENT 2020; 65:257-271. [PMID: 31828410 DOI: 10.1007/s00267-019-01239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
Environmental contamination, a legacy of industrial activity borne by numerous sites around the world, poses health risks for surrounding communities and presents serious cleanup challenges. One such site, the Santa Susana Field Laboratory (SSFL), served as an aerospace and nuclear energy research facility for over 50 years, during which time radioactive and other hazardous materials were unintentionally and intentionally released into the surrounding environment. These releases, including the partial meltdown of a sodium reactor, were hidden from the public for three decades. The site is now located in suburban Los Angeles, with 730,000 people living within a 10-mile radius. This paper evaluates the technical and social challenges underlying site cleanup at SSFL, including a complex geological setting, uncertain contaminant information, and a convoluted, evolving regulatory framework. These challenges, paired with historical secrecy on the part of responsible organizations and unclear layers of responsibility, have led to uncertainty and distrust within the surrounding community. Lessons learned from other remediated sites are assessed and recommendations for the SSFL cleanup are provided.
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Affiliation(s)
- Nicola Ulibarri
- Department of Urban Planning and Public Policy, University of California, Irvine, 300 Social Ecology I, Irvine, CA, 92697, USA.
| | - Cameron L Tracy
- Belfer Center for Science and International Affairs, Kennedy School of Government, Harvard University, 79 John F. Kennedy St, Cambridge, MA, 02138, USA
| | - Ryan J McCarty
- Department of Chemistry, University of California, Irvine, Natural Sciences II, Irvine, CA, 92697, USA
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Meyer C, Millán P, González V, Spera G, Machado A, Mackey JR, Fresco R. Intensive Imaging Surveillance of Survivors of Breast Cancer May Increase Risk of Radiation-induced Malignancy. Clin Breast Cancer 2019; 19:e468-e474. [PMID: 30850181 DOI: 10.1016/j.clbc.2019.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Current clinical guidelines recommend mammography as the only imaging method for surveillance in asymptomatic survivors of early breast cancer (EBC). However, non-recommended tests are commonly used. We estimated the imaging radiation-induced malignancies (IRIM) risks in survivors of EBC undergoing different imaging surveillance models. MATERIALS AND METHODS We built 5 theoretical models of imaging surveillance, from annual mammography only (model 1) to increasingly imaging-intensive approaches, including computed tomography (CT) scan, positron emission tomography-CT, bone scan, and multigated acquisition scan (models 2 through 5). Using the National Cancer Institute's Radiation Risk Assessment Tool, we compared the excess lifetime attributable cancer risk (LAR) for hypothetical survivors of EBC starting surveillance at the ages of 30, 60, or 75 years and ending at 81 years. RESULTS For all age groups analyzed, there is a statistically significant increase in LAR when comparing model 1 with more intensive models. As an example, in a patient beginning surveillance at the age of 60 years, there is a 28.5-fold increase in the IRIM risk when comparing mammography only versus a schedule with mammography plus CT scan of chest-abdomen and bone scan. We found no differences when comparing models 2 through 5. LAR is higher when surveillance starts at a younger age, although the age effect was only statistically significant in model 1. CONCLUSION Non-recommended imaging during EBC surveillance can be associated with a significant increase in LAR. In addition to the lack of survival benefit, additional tests may have significant IRIM risks and should be avoided.
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Affiliation(s)
- Carlos Meyer
- Medical Unit, Translational Research In Oncology (TRIO), Montevideo, Uruguay
| | - Pablo Millán
- Medical Unit, Translational Research In Oncology (TRIO), Montevideo, Uruguay.
| | - Valeria González
- Medical Unit, Translational Research In Oncology (TRIO), Montevideo, Uruguay
| | - Gonzalo Spera
- Medical Unit, Translational Research In Oncology (TRIO), Montevideo, Uruguay
| | - Andrés Machado
- Medical Unit, Translational Research In Oncology (TRIO), Montevideo, Uruguay
| | - John R Mackey
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Rodrigo Fresco
- Medical Unit, Translational Research In Oncology (TRIO), Montevideo, Uruguay
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Jang JS, Yang HJ, Koo HJ, Kim SH, Park CR, Yoon SH, Shin SY, Do KH. Image quality assessment with dose reduction using high kVp and additional filtration for abdominal digital radiography. Phys Med 2018; 50:46-51. [PMID: 29891093 DOI: 10.1016/j.ejmp.2018.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 05/04/2018] [Accepted: 05/06/2018] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Dose reduction using additional filters with high kilovoltage peak (kVp) for abdominal digital radiography has received much attention recently. We evaluated image quality with dose reduction in abdominal digital radiography by using high kVp and additional copper filters at a tertiary hospital. METHODS Between June 2016 and July 2016, 82 patients underwent abdominal digital radiography using 80 kVp in X-ray room 1 and 82 were imaged using 92 kVp with 0.1-mm copper filtration in X-ray room 2. The effective dose was calculated using a PC-based Monte Carlo program. Image quality of the abdominal radiography acquired in the two rooms was evaluated using a five-point ordinal scale, as well as the signal-to-noise and contrast-to-noise ratios. RESULTS The mean effective dose decreased by 25.8% and 25.7% for the supine and standing positions, respectively, when abdominal digital radiography using 92 kVp with 0.1-mm copper filtration was performed. In the 20 patients who performed abdominal digital radiography twice in each room, visual grading scores for visualisation of psoas outlines and kidney outlines are higher in room 1. However, there was no statistical significant difference of visual grading scores among the 124 patients who underwent only one abdominal radiography in the room 1 or 2 (P > 0.05). CONCLUSIONS Dose reduction for abdominal digital radiography can be achieved with comparable image quality by performing abdominal digital radiography using 92 kVp with 0.1-mm copper filtration, despite the higher AEC dose.
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Affiliation(s)
- Ji Sung Jang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea; Department of Medical Physics, Korea University, South Korea
| | - Hyung Jin Yang
- Department of Medical Physics, Korea University, South Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea
| | - Sung Ho Kim
- Department of Medical Physics, Korea University, South Korea
| | - Chan Rok Park
- Department of Medical Physics, Korea University, South Korea
| | - Suk Hwan Yoon
- Department of Medical Physics, Korea University, South Korea
| | - So Youn Shin
- Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Kyung-Hyun Do
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.
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M Ali RMK, England A, Mercer C, Tootell A, Walton L, Schaake W, Hogg P. Mathematical modelling of radiation-induced cancer risk from breast screening by mammography. Eur J Radiol 2017; 96:98-103. [PMID: 29103483 DOI: 10.1016/j.ejrad.2017.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 08/06/2017] [Accepted: 10/01/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Establish a method to determine and convey lifetime radiation risk from FFDM screening. METHODS Radiation risk from screening mammography was quantified using effective risk (number of radiation-induced cancer cases/million). For effective risk calculations, organ doses and examined breast MGD were used. Screening mammography was simulated by exposing a breast phantom for cranio-caudal and medio-lateral oblique for each breast using 16 FFDM machines. An ATOM phantom loaded with TLD dosimeters was positioned in contact with the breast phantom to simulate the client's body. Effective risk data were analysed using SPSS software to establish a regression model to predict the effective risk of any screening programme. Graphs were generated to extrapolate the effective risk of all screening programmes for a range of commencement ages and time intervals between screens. RESULTS The most important parameters controlling clients' total effective risk within breast screening are the screening commencement age and number of screens (correlation coefficients were -0.865 and 0.714, respectively). Since the tissue radio-sensitivity reduces with age, the end age of screening does not result in noteworthy effect on total effective risk. CONCLUSIONS The regression model can be used to predict the total effective risk for clients within breast screening but it cannot be used for exact assessment of total effective risk. Graphical representation of risk could be an easy way to represent risk in a fashion which might be helpful to clients and clinicians.
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Affiliation(s)
- Raed M K M Ali
- Faculty of Medicine, University of Kufa, Iraq; University of Salford, UK.
| | | | | | | | | | - Wouter Schaake
- Department of Medical Imaging and Radiation Therapy, Hanze University of Applied Sciences, Eyssoniusplein 18, 9714 CE Groningen, The Netherlands.
| | - Peter Hogg
- University of Salford, UK; Karolinska Institute, Sweden.
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Bianca S. Health Risks of Low-Dose Ionizing Radiation in Humans. Exp Biol Med (Maywood) 2016; 230:99-100; discussion 101. [PMID: 15673555 DOI: 10.1177/153537020523000201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sebastiano Bianca
- Centro di Consulenza Genetica e di Teratologia della Riproduzione, PO Garibaldi-Nesima, Via Palermo, 95122 Catania, Italy.
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Sabadashka M, Sybirna N. Reduction of radiation-induced nitrative stress in leucocytes and kidney cells of rats upon administration of polyphenolic complex concentrates from red wine. CYTOL GENET+ 2016. [DOI: 10.3103/s0095452716030099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Karapiperis C, Kempf SJ, Quintens R, Azimzadeh O, Vidal VL, Pazzaglia S, Bazyka D, Mastroberardino PG, Scouras ZG, Tapio S, Benotmane MA, Ouzounis CA. Brain Radiation Information Data Exchange (BRIDE): integration of experimental data from low-dose ionising radiation research for pathway discovery. BMC Bioinformatics 2016; 17:212. [PMID: 27170263 PMCID: PMC4865096 DOI: 10.1186/s12859-016-1068-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 04/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The underlying molecular processes representing stress responses to low-dose ionising radiation (LDIR) in mammals are just beginning to be understood. In particular, LDIR effects on the brain and their possible association with neurodegenerative disease are currently being explored using omics technologies. RESULTS We describe a light-weight approach for the storage, analysis and distribution of relevant LDIR omics datasets. The data integration platform, called BRIDE, contains information from the literature as well as experimental information from transcriptomics and proteomics studies. It deploys a hybrid, distributed solution using both local storage and cloud technology. CONCLUSIONS BRIDE can act as a knowledge broker for LDIR researchers, to facilitate molecular research on the systems biology of LDIR response in mammals. Its flexible design can capture a range of experimental information for genomics, epigenomics, transcriptomics, and proteomics. The data collection is available at: .
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Affiliation(s)
- Christos Karapiperis
- Department of Genetics, Development & Molecular Biology, School of Biology, Aristotle University of Thessalonica, 54124, Thessalonica, Greece
| | - Stefan J Kempf
- Institute of Radiation Biology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
- Present address: Department of Biochemistry and Molecular Biology, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Roel Quintens
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK•CEN), B-2400, Mol, Belgium
| | - Omid Azimzadeh
- Institute of Radiation Biology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Victoria Linares Vidal
- School of Medicine, IISPV, "Rovira i Virgili" University, Sant Llorens 21, 43201, Reus, Spain
| | - Simonetta Pazzaglia
- Laboratory of Radiation Biology & Biomedicine, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA) Centro Ricerche Casaccia, 00123, Rome, Italy
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, Melnykov str. 53, Kyiv, 04050, Ukraine
| | | | - Zacharias G Scouras
- Department of Genetics, Development & Molecular Biology, School of Biology, Aristotle University of Thessalonica, 54124, Thessalonica, Greece
| | - Soile Tapio
- Institute of Radiation Biology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany.
| | | | - Christos A Ouzounis
- Department of Genetics, Development & Molecular Biology, School of Biology, Aristotle University of Thessalonica, 54124, Thessalonica, Greece.
- Biological Process & Computation Laboratory (BCPL), Chemical Process & Energy Resources Institute (CPERI), Centre for Research & Technology Hellas (CERTH), Thessalonica, 57001, Greece.
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Bjurlin MA, Rosenkrantz AB, Beltran LS, Raad RA, Taneja SS. Imaging and evaluation of patients with high-risk prostate cancer. Nat Rev Urol 2015; 12:617-28. [PMID: 26481576 DOI: 10.1038/nrurol.2015.242] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Approximately 15% of men with newly diagnosed prostate cancer have high-risk disease. Imaging is critically important for the diagnosis and staging of these patients, and also for the selection of management. While established prostate cancer staging guidelines have increased the appropriate use of imaging, underuse for high-risk prostate cancer remains substantial. Several factors affect the utility of initial diagnostic imaging, including the variable definition of high-risk prostate cancer, variable guideline recommendations, poor accuracy of existing imaging tests, and the difficulty in validating imaging findings. Conventional imaging modalities, including CT and radionuclide bone scan, have been employed for local and metastatic staging, but their performance characteristics have generally been poor. Emerging modalities including multiparametricMRI, positron emission tomography (PET)-CT, and PET-MRI have shown increased diagnostic accuracy and could improve accuracy in staging patients with high-risk prostate cancer.
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Affiliation(s)
- Marc A Bjurlin
- Division of Urologic Oncology, Department of Urology, New York University Langone Medical Center, New York, NY 10016, USA
| | - Andrew B Rosenkrantz
- Department of Radiology, New York University Langone Medical Center, New York, NY 10016, USA
| | - Luis S Beltran
- Department of Radiology, New York University Langone Medical Center, New York, NY 10016, USA
| | - Roy A Raad
- Department of Radiology, New York University Langone Medical Center, New York, NY 10016, USA
| | - Samir S Taneja
- Division of Urologic Oncology, Department of Urology, New York University Langone Medical Center, New York, NY 10016, USA
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Zafar T, Masood K, Zafar J. Assessment of personal occupational radiation exposures received by nuclear medicine and oncology staff in Punjab (2003–2012). AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2015; 38:473-8. [DOI: 10.1007/s13246-015-0368-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 08/03/2015] [Indexed: 11/30/2022]
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Fresco R, Spera G, Meyer C, Cabral P, Mackey JR. Imaging Radiation Doses and Associated Risks and Benefits in Subjects Participating in Breast Cancer Clinical Trials. Oncologist 2015; 20:702-12. [PMID: 26025934 PMCID: PMC4492226 DOI: 10.1634/theoncologist.2014-0295] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 03/05/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Medical imaging is commonly required in breast cancer (BC) clinical trials to assess the efficacy and/or safety of study interventions. Despite the lack of definitive epidemiological data linking imaging radiation with cancer development in adults, concerns exist about the risks of imaging radiation-induced malignancies (IRIMs) in subjects exposed to repetitive imaging. We estimated the imaging radiation dose and IRIM risk in subjects participating in BC trials. MATERIALS AND METHODS The imaging protocol requirements in 10 phase III trials in the adjuvant and advanced settings were assessed to estimate the effective radiation dose received by a typical and fully compliant subject in each trial. For each study, the excess lifetime attributable cancer risk (LAR) was calculated using the National Cancer Institute's Radiation Risk Assessment Tool, version 3.7.1. Dose and risk calculations were performed for both imaging intensive and nonintensive approaches to reflect the variability in imaging performed within the studies. RESULTS The total effective imaging radiation dose was 0.4-262.2 mSv in adjuvant trials and 26-241.3 mSv in metastatic studies. The dose variability resulted from differing protocol requirements and imaging intensity approaches, with computed tomography, multigated acquisition scans, and bone scans as the major contributors. The mean LAR was 1.87-2,410/100,000 in adjuvant trials (IRIM: 0.0002%-2.41% of randomized subjects) and 6.9-67.3/100,000 in metastatic studies (IRIM: 0.007%-0.067% of subjects). CONCLUSION IRIMs are infrequent events. In adjuvant trials, aligning the protocol requirements with the clinical guidelines' surveillance recommendations and substituting radiating procedures with equivalent nonradiating ones would reduce IRIM risk. No significant risk has been observed in metastatic trials, and potential concerns on IRIMs are not justified. IMPLICATIONS FOR PRACTICE Medical imaging is key in breast cancer (BC) clinical trials. Most of these procedures expose patients to ionizing radiation, and the risk of second cancer development after imaging has prompted recent concerns and controversy. Using accepted calculation models, the number of malignancies were estimated that were potentially attributable to the imaging procedures performed during a patient's participation in BC clinical trials. The results show that for patients participating in metastatic trials, the risk of imaging radiation-induced malignancies is negligible. In adjuvant trials, some second cancers due to imaging could be expected, and measures can be taken to reduce their risk.
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Affiliation(s)
- Rodrigo Fresco
- Medical Lead Department, Translational Research in Oncology, Montevideo, Uruguay; Departamento de Radiofarmacia, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay; Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Gonzalo Spera
- Medical Lead Department, Translational Research in Oncology, Montevideo, Uruguay; Departamento de Radiofarmacia, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay; Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Meyer
- Medical Lead Department, Translational Research in Oncology, Montevideo, Uruguay; Departamento de Radiofarmacia, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay; Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Pablo Cabral
- Medical Lead Department, Translational Research in Oncology, Montevideo, Uruguay; Departamento de Radiofarmacia, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay; Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - John R Mackey
- Medical Lead Department, Translational Research in Oncology, Montevideo, Uruguay; Departamento de Radiofarmacia, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay; Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
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Madrigano RR, Abrão KC, Puchnick A, Regacini R. Evaluation of non-radiologist physicians' knowledge on aspects related to ionizing radiation in imaging. Radiol Bras 2015; 47:210-6. [PMID: 25741087 PMCID: PMC4337119 DOI: 10.1590/0100-3984.2013.1840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 02/06/2014] [Indexed: 01/21/2023] Open
Abstract
Objective To assess the non-radiologist physicians' knowledge on the use of ionizing
radiation in imaging. Materials and Methods Cross-sectional study utilizing an anonymous questionnaire responded by physicians
in clinical and surgical specialties, divided into two parts as follows: one
including questions about the physicians' characteristics, frequency of imaging
studies requests and participation in professional updating events, and another
part including multiple choice questions approaching general knowledge about
radiation, optimization principles and radioprotection. Results From a total of 309 questionnaires, 120 (38.8%) were responded, 50% by physicians
in surgical specialties and 50% in clinical specialties; respectively 45% and 2.5%
of physicians responded that magnetic resonance imaging and ultrasonography use
ionizing radiation. Overall, the average grade was higher for surgical specialists
with no significant difference, except for the question about exposure in pregnant
women (p = 0.047). Physicians who are professionally updated,
particularly those attending clinical meetings (p = 0.050) and
participating in teaching activities (p = 0.047), showed
statistically superior knowledge about ionizing radiation as compared with
others. Conclusion The non-radiologist physicians' knowledge is heterogeneous and in some points
needs to be improved. Multidisciplinary clinical meetings and teaching activities
are important ways to disseminate information on the subject.
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Affiliation(s)
| | - Karen Cristine Abrão
- Teacher and Assistant Academic Director, Escola de Medicina da Universidade Anhembi Morumbi, PhD, Department of Gynecology and Obstetrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Andrea Puchnick
- Professor, Coordinator for Support to Teaching and Research, Department of Imaging Diagnosis, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Rodrigo Regacini
- Teacher of Morphology and Radiology and Imaging Diagnosis, School of Medicine - Universidade Anhembi Morumbi, MD, Pediatric Radiologist and Fellow Master degree, Department of Imaging Diagnosis, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
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Ha CT, Li XH, Fu D, Moroni M, Fisher C, Arnott R, Srinivasan V, Xiao M. Circulating interleukin-18 as a biomarker of total-body radiation exposure in mice, minipigs, and nonhuman primates (NHP). PLoS One 2014; 9:e109249. [PMID: 25290447 PMCID: PMC4188589 DOI: 10.1371/journal.pone.0109249] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 09/04/2014] [Indexed: 12/21/2022] Open
Abstract
We aim to develop a rapid, easy-to-use, inexpensive and accurate radiation dose-assessment assay that tests easily obtained samples (e.g., blood) to triage and track radiological casualties, and to evaluate the radioprotective and therapeutic effects of radiation countermeasures. In the present study, we evaluated the interleukin (IL)-1 family of cytokines, IL-1β, IL-18 and IL-33, as well as their secondary cytokines’ expression and secretion in CD2F1 mouse bone marrow (BM), spleen, thymus and serum in response to γ-radiation from sublethal to lethal doses (5, 7, 8, 9, 10, or 12 Gy) at different time points using the enzyme-linked immune sorbent assay (ELISA), immunoblotting, and cytokine antibody array. Our data identified increases of IL-1β, IL-18, and/or IL-33 in mouse thymus, spleen and BM cells after total-body irradiation (TBI). However, levels of these cytokines varied in different tissues. Interestingly, IL-18 but not IL-1β or IL-33 increased significantly (2.5–24 fold) and stably in mouse serum from day 1 after TBI up to 13 days in a radiation dose-dependent manner. We further confirmed our finding in total-body γ-irradiated nonhuman primates (NHPs) and minipigs, and demonstrated that radiation significantly enhanced IL-18 in serum from NHPs 2–4 days post-irradiation and in minipig plasma 1–3 days post-irradiation. Finally, we compared circulating IL-18 with the well known hematological radiation biomarkers lymphocyte and neutrophil counts in blood of mouse, minipigs and NHPs and demonstrated close correlations between these biomarkers in response to radiation. Our results suggest that the elevated levels of circulating IL-18 after radiation proportionally reflect radiation dose and severity of radiation injury and may be used both as a potential biomarker for triage and also to track casualties after radiological accidents as well as for therapeutic radiation exposure.
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Affiliation(s)
- Cam T. Ha
- Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Xiang-Hong Li
- Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Dadin Fu
- Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Maria Moroni
- Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Carolyn Fisher
- Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Robert Arnott
- Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Venkataraman Srinivasan
- Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Mang Xiao
- Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- * E-mail:
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22
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Baratz MD, Hu YY, Zurakowski D, Appleton P, Rodriguez EK. The primary determinants of radiation use during fixation of proximal femur fractures. Injury 2014; 45:1614-9. [PMID: 24957423 DOI: 10.1016/j.injury.2014.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Revised: 12/18/2013] [Accepted: 05/08/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To establish the primary determinants of operative radiation use during fixation of proximal femur fractures. DESIGN Retrospective cohort study. SETTING Level I trauma centre. COHORT 205 patients treated surgically for subtrochanteric and intertrochanteric femoral fractures. MAIN OUTCOME MEASURES Fluoroscopy time, dose-area-product (DAP). RESULTS Longer fluoroscopy time was correlated with higher body mass index (p=0.04), subtrochanteric fracture (p<0.001), attending surgeon (p=0.001), and implant type (p<0.001). Increased DAP was associated with higher body mass index (p<0.001), subtrochanteric fracture (p=0.002), attending surgeon (p=0.003), lateral body position (p<0.001), and implant type (p=0.05). CONCLUSION The strongest determinants of radiation use during surgical fixation of intertrochanteric and subtrochanteric femur fractures were location of fracture, patient body position, patient body mass index, and the use of cephalomedullary devices. Surgeon style, presumably as it relates to teaching efforts, seems to strongly influence radiation use.
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Affiliation(s)
- Michael D Baratz
- Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA, United States.
| | - Yue-Yung Hu
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States.
| | - David Zurakowski
- Department of Anesthesia, Children's Hospital Boston, Boston, MA, United States.
| | - Paul Appleton
- Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA, United States.
| | - Edward K Rodriguez
- Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA, United States.
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Mothersill C, Seymour C. Implications for human and environmental health of low doses of ionising radiation. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2014; 133:5-9. [PMID: 23664231 DOI: 10.1016/j.jenvrad.2013.04.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 04/01/2013] [Accepted: 04/03/2013] [Indexed: 05/20/2023]
Abstract
The last 20 years have seen a major paradigm shift in radiation biology. Several discoveries challenge the DNA centric view which holds that DNA damage is the critical effect of radiation irrespective of dose. This theory leads to the assumption that dose and effect are simply linked - the more energy deposition, the more DNA damage and the greater the biological effect. This is embodied in radiation protection (RP) regulations as the linear-non-threshold (LNT) model. However the science underlying the LNT model is being challenged particularly in relation to the environment because it is now clear that at low doses of concern in RP, cells, tissues and organisms respond to radiation by inducing responses which are not readily predictable by dose. These include adaptive responses, bystander effects, genomic instability and low dose hypersensitivity, and are commonly described as stress responses, while recognizing that "stress" can be good as well as bad. The phenomena contribute to observed radiation responses and appear to be influenced by genetic, epigenetic and environmental factors, meaning that dose and response are not simply related. The question is whether our discovery of these phenomena means that we need to re-evaluate RP approaches. The so-called "non-targeted" mechanisms mean that low dose radiobiology is very complex and supra linear or sub-linear (even hormetic) responses are possible but their occurrence is unpredictable for any given system level. Issues which may need consideration are synergistic or antagonistic effects of other pollutants. RP, at present, only looks at radiation dose but the new (NTE) radiobiology means that chemical or physical agents, which interfere with tissue responses to low doses of radiation, could critically modulate the predicted risk. Similarly, the "health" of the organism could determine the effect of a given low dose by enabling or disabling a critical response. These issues will be discussed.
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Affiliation(s)
- Carmel Mothersill
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada L8S 4K1.
| | - Colin Seymour
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada L8S 4K1
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Xie T, Bolch WE, Lee C, Zaidi H. Pediatric radiation dosimetry for positron-emitting radionuclides using anthropomorphic phantoms. Med Phys 2014; 40:102502. [PMID: 24089923 DOI: 10.1118/1.4819939] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Positron emission tomography (PET) plays an important role in the diagnosis, staging, treatment, and surveillance of clinically localized diseases. Combined PET/CT imaging exhibits significantly higher sensitivity, specificity, and accuracy than conventional imaging when it comes to detecting malignant tumors in children. However, the radiation dose from positron-emitting radionuclide to the pediatric population is a matter of concern since children are at a particularly high risk when exposed to ionizing radiation. METHODS The authors evaluate the absorbed fractions and specific absorbed fractions (SAFs) of monoenergy photons/electrons as well as S-values of 9 positron-emitting radionuclides (C-11, N-13, O-15, F-18, Cu-64, Ga-68, Rb-82, Y-86, and I-124) in 48 source regions for 10 anthropomorphic pediatric hybrid models, including the reference newborn, 1-, 5-, 10-, and 15-yr-old male and female models, using the Monte Carlo N-Particle eXtended general purpose Monte Carlo transport code. RESULTS The self-absorbed SAFs and S-values for most organs were inversely related to the age and body weight, whereas the cross-dose terms presented less correlation with body weight. For most source/target organ pairs, Rb-82 and Y-86 produce the highest self-absorbed and cross-absorbed S-values, respectively, while Cu-64 produces the lowest S-values because of the low-energy and high-frequency of electron emissions. Most of the total self-absorbed S-values are contributed from nonpenetrating particles (electrons and positrons), which have a linear relationship with body weight. The dependence of self-absorbed S-values of the two annihilation photons varies to the reciprocal of 0.76 power of the mass, whereas the self-absorbed S-values of positrons vary according to the reciprocal mass. CONCLUSIONS The produced S-values for common positron-emitting radionuclides can be exploited for the assessment of radiation dose delivered to the pediatric population from various PET radiotracers used in clinical and research settings. The mass scaling method for positron-emitters can be used to derive patient-specific S-values from data of reference phantoms.
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Affiliation(s)
- Tianwu Xie
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211 Geneva 4, Switzerland
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Kiuru A, Kämäräinen M, Heinävaara S, Pylkäs K, Chapman K, Koivistoinen A, Parviainen T, Winqvist R, Kadhim M, Launonen V, Lindholm C. Assessment of targeted and non-targeted responses in cells deficient in ATM function following exposure to low and high dose X-rays. PLoS One 2014; 9:e93211. [PMID: 24681528 PMCID: PMC3969311 DOI: 10.1371/journal.pone.0093211] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 03/03/2014] [Indexed: 12/05/2022] Open
Abstract
Radiation sensitivity at low and high dose exposure to X-rays was investigated by means of chromosomal aberration (CA) analysis in heterozygous ATM mutation carrier and A-T patient (biallelic ATM mutation) lymphoblastoid cell lines (LCLs). Targeted and non-targeted responses to acutely delivered irradiation were examined by applying a co-culture system that enables study of both directly irradiated cells and medium-mediated bystander effects in the same experimental setting. No indication of radiation hypersensitivity was observed at doses of 0.01 Gy or 0.1 Gy for the ATM mutation carrier LCL. The A-T patient cells also did not show low-dose response. There was significant increase in unstable CA yields for both ATM mutation carrier and A-T LCLs at 1 and 2 Gy, the A-T cells displaying more distinct dose dependency. Both chromosome and chromatid type aberrations were induced at an increased rate in the irradiated A-T cells, whereas for ATM carrier cells, only unstable chromosomal aberrations were increased above the level observed in the wild type cell line. No bystander effect could be demonstrated in any of the cell lines or doses applied. Characteristics typical for the A-T cell line were detected, i.e., high baseline frequency of CA that increased with dose. In addition, dose-dependent loss of cell viability was observed. In conclusion, CA analysis did not demonstrate low-dose (≤100 mGy) radiosensitivity in ATM mutation carrier cells or A-T patient cells. However, both cell lines showed increased radiosensitivity at high dose exposure.
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Affiliation(s)
- Anne Kiuru
- STUK-Radiation and Nuclear Safety Authority, Helsinki, Finland
| | | | | | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
| | | | | | | | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
| | | | - Virpi Launonen
- STUK-Radiation and Nuclear Safety Authority, Helsinki, Finland
| | - Carita Lindholm
- STUK-Radiation and Nuclear Safety Authority, Helsinki, Finland
- * E-mail:
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Alexandrou AT, Li JJ. Cell cycle regulators guide mitochondrial activity in radiation-induced adaptive response. Antioxid Redox Signal 2014; 20:1463-80. [PMID: 24180340 PMCID: PMC3936506 DOI: 10.1089/ars.2013.5684] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
SIGNIFICANCE There are accruing concerns on potential genotoxic agents present in the environment including low-dose ionizing radiation (LDIR) that naturally exists on earth's surface and atmosphere and is frequently used in medical diagnosis and nuclear industry. Although its long-term health risk is being evaluated and remains controversial, LDIR is shown to induce temporary but significant adaptive responses in mammalian cells and animals. The mechanisms guiding the mitochondrial function in LDIR-induced adaptive response represent a unique communication between DNA damage and cellular metabolism. Elucidation of the LDIR-regulated mitochondrial activity may reveal new mechanisms adjusting cellular function to cope with hazardous environmental stress. RECENT ADVANCES Key cell cycle regulators, including Cyclin D1/CDK4 and Cyclin B1/cyclin-dependent kinase 1 (CDK1) complexes, are actively involved in the regulation of mitochondrial functions via phosphorylation of their mitochondrial targets. Accumulating new evidence supports a concept that the Cyclin B1/CDK1 complex acts as a mediator in the cross talk between radiation-induced DNA damage and mitochondrial functions to coordinate cellular responses to low-level genotoxic stresses. CRITICAL ISSUES The LDIR-mediated mitochondrial activity via Cyclin B1/CDK1 regulation is an irreplaceable network that is able to harmonize vital cellular functions with adjusted mitochondrial metabolism to enhance cellular homeostasis. FUTURE DIRECTIONS Further investigation of the coordinative mechanism that regulates mitochondrial activities in sublethal stress conditions, including LDIR, will reveal new insights of how cells cope with genotoxic injury and will be vital for future targeted therapeutic interventions that reduce environmental injury and cancer risk.
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Affiliation(s)
- Aris T Alexandrou
- Department of Radiation Oncology, NCI-Designated Comprehensive Cancer Center, University of California at Davis , Sacramento, California
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27
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Xie T, Zaidi H. Evaluation of radiation dose to anthropomorphic paediatric models from positron-emitting labelled tracers. Phys Med Biol 2014; 59:1165-87. [PMID: 24557029 DOI: 10.1088/0031-9155/59/5/1165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PET uses specific molecules labelled with positron-emitting radionuclides to provide valuable biochemical and physiological information. However, the administration of radiotracers to patients exposes them to low-dose ionizing radiation, which is a concern in the paediatric population since children are at a higher cancer risk from radiation exposure than adults. Therefore, radiation dosimety calculations for commonly used positron-emitting radiotracers in the paediatric population are highly desired. We evaluate the absorbed dose and effective dose for 19 positron-emitting labelled radiotracers in anthropomorphic paediatric models including the newborn, 1-, 5-, 10- and 15-year-old male and female. This is achieved using pre-calculated S-values of positron-emitting radionuclides of UF-NCI paediatric phantoms and published biokinetic data for various radiotracers. The influence of the type of anthropomorphic model, tissue weight factors and direct human- versus mouse-derived biokinetic data on the effective dose for paediatric phantoms was also evaluated. In the case of (18)F-FDG, dosimetry calculations of reference paediatric patients from various dose regimens were also calculated. Among the considered radiotracers, (18)F-FBPA and (15)O-water resulted in the highest and lowest effective dose in the paediatric phantoms, respectively. The ICRP 103 updated tissue-weighting factors decrease the effective dose in most cases. Substantial differences of radiation dose were observed between direct human- versus mouse-derived biokinetic data. Moreover, the effect of using voxel- versus MIRD-type models on the calculation of the effective dose was also studied. The generated database of absorbed organ dose and effective dose for various positron-emitting labelled radiotracers using new generation computational models and the new ICRP tissue-weighting factors can be used for the assessment of radiation risks to paediatric patients in clinical practice. This work also contributes to a better understanding of the factors influencing patient-specific radiation dose calculation.
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Affiliation(s)
- Tianwu Xie
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211 Geneva 4, Switzerland
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Eken A, Aydin A, Erdem O, Akay C, Sayal A, Somuncu İ. Induced antioxidant activity in hospital staff occupationally exposed to ionizing radiation. Int J Radiat Biol 2012; 88:648-53. [DOI: 10.3109/09553002.2012.702295] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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29
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Xu L, Morari EC, Wei Q, Sturgis EM, Ward LS. Functional variations in the ATM gene and susceptibility to differentiated thyroid carcinoma. J Clin Endocrinol Metab 2012; 97:1913-21. [PMID: 22438227 PMCID: PMC3387410 DOI: 10.1210/jc.2011-3299] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT ATM is critical in response to ionizing radiation-induced DNA damage. OBJECTIVE Variations in ATM are hypothesized to affect individual susceptibility to thyroid cancer. Our objective was to evaluate the association between ATM polymorphisms and thyroid cancer risk. DESIGN, PARTICIPANTS, AND METHODS Six ATM single nucleotide polymorphisms (SNP) were genotyped in two independent case-control series including 592 patients with differentiated thyroid carcinoma (DTC) and 885 healthy individuals. An unconditional logistic regression model was applied to calculate odds ratios (OR) and 95% confidence intervals (CI) for each SNP with respect to risk of DTC and the combination effect of SNP on cancer risk. RESULTS The risk-allele frequencies of all the SNP were similar in the two case-control populations. Under a dominant model of inheritance, the G allele of ATM rs189037 exhibited a protective effect against DTC (adjusted OR = 0.8; 95% CI, 0.6-1.0; P = 0.04), and the G allele of rs1800057 was associated with increased risk of DTC (adjusted OR = 1.9; 95% CI, 1.1-3.1; P = 0.02). A protective haplotype (A-G-C-T-C-A) was associated with decreased risk of DTC in non-Hispanic whites (adjusted OR = 0.2; 95% CI, 0.0-0.8; P = 0.03). A significant dose-response relationship was observed between the total number of risk alleles of ATM and DTC risk (P = 0.01). Carriers of a combination of six to seven and eight to 10 risk alleles were at 30% (adjusted OR = 1.3; 95% CI, 1.0-1.7) and 50% (adjusted OR = 1.5; 95% CI, 1.1-2.1) increased risk of DTC, respectively. CONCLUSION Individual susceptibility to DTC may be attributable to polymorphisms of ATM, and the associations warrant confirmation in independent studies.
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Affiliation(s)
- Li Xu
- Departments of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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30
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Saeed M, Hetts SW, English J, Wilson M. MR fluoroscopy in vascular and cardiac interventions (review). Int J Cardiovasc Imaging 2012; 28:117-37. [PMID: 21359519 PMCID: PMC3275732 DOI: 10.1007/s10554-010-9774-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Accepted: 12/13/2010] [Indexed: 12/22/2022]
Abstract
Vascular and cardiac disease remains a leading cause of morbidity and mortality in developed and emerging countries. Vascular and cardiac interventions require extensive fluoroscopic guidance to navigate endovascular catheters. X-ray fluoroscopy is considered the current modality for real time imaging. It provides excellent spatial and temporal resolution, but is limited by exposure of patients and staff to ionizing radiation, poor soft tissue characterization and lack of quantitative physiologic information. MR fluoroscopy has been introduced with substantial progress during the last decade. Clinical and experimental studies performed under MR fluoroscopy have indicated the suitability of this modality for: delivery of ASD closure, aortic valves, and endovascular stents (aortic, carotid, iliac, renal arteries, inferior vena cava). It aids in performing ablation, creation of hepatic shunts and local delivery of therapies. Development of more MR compatible equipment and devices will widen the applications of MR-guided procedures. At post-intervention, MR imaging aids in assessing the efficacy of therapies, success of interventions. It also provides information on vascular flow and cardiac morphology, function, perfusion and viability. MR fluoroscopy has the potential to form the basis for minimally invasive image-guided surgeries that offer improved patient management and cost effectiveness.
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Affiliation(s)
- Maythem Saeed
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107-1701, USA.
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Farooque A, Mathur R, Verma A, Kaul V, Bhatt AN, Adhikari JS, Afrin F, Singh S, Dwarakanath BS. Low-dose radiation therapy of cancer: role of immune enhancement. Expert Rev Anticancer Ther 2011; 11:791-802. [PMID: 21554054 DOI: 10.1586/era.10.217] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The efficacy of conventional radiation therapy, one of the most widely used treatment modalities of cancer, is limited by resistance of tumors as well as normal tissue toxicity. In the last decade, several studies have shown that protocols using low-dose radiation (LDR) are more effective in providing local tumor control with negligible normal tissue toxicity. LDR stimulates antioxidant capacity, repair of DNA damage, apoptosis and induction of immune responses, which might be collectively responsible for providing effective local tumor control. This article focuses on the immunostimulatory effects of LDR in in vivo models and its clinical efficacy, supporting the use of LDR regimens (alone or as adjuvant) as an anticancer treatment.
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Affiliation(s)
- Abdullah Farooque
- Division of Radiation Biosciences, Institute of Nuclear Medicine and Allied Sciences, Brig. SK Mazumdar Road, Delhi 110 0054, India
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Belchior A, Gil OM, Almeida P, Vaz P. Evaluation of the cytotoxicity and the genotoxicity induced by α radiation in an A549 cell line. RADIAT MEAS 2011. [DOI: 10.1016/j.radmeas.2011.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Takai D, Todate A, Yanai T, Ichinohe K, Oghiso Y. Enhanced transplantability of a cell line from a murine ovary granulosa cell tumour in syngeneic B6C3F1mice continuously irradiated with low dose-rate gamma-rays. Int J Radiat Biol 2011; 87:729-35. [DOI: 10.3109/09553002.2010.545861] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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34
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Reiner DM, Nuttall WJ. Public Acceptance of Geological Disposal of Carbon Dioxide and Radioactive Waste: Similarities and Differences. ADVANCES IN GLOBAL CHANGE RESEARCH 2011. [DOI: 10.1007/978-90-481-8712-6_10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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35
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Ishida Y, Takabatake T, Kakinuma S, Doi K, Yamauchi K, Kaminishi M, Kito S, Ohta Y, Amasaki Y, Moritake H, Kokubo T, Nishimura M, Nishikawa T, Hino O, Shimada Y. Genomic and gene expression signatures of radiation in medulloblastomas after low-dose irradiation in Ptch1 heterozygous mice. Carcinogenesis 2010; 31:1694-701. [PMID: 20616149 DOI: 10.1093/carcin/bgq145] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Accurate cancer risk assessment of low-dose radiation poses many challenges that are partly due to the inability to distinguish radiation-induced tumors from spontaneous ones. To elucidate characteristic features of radiation-induced tumors, we analyzed 163 medulloblastomas that developed either spontaneously or after X-ray irradiation at doses of 0.05-3 Gy in Ptch1 heterozygous mice. All spontaneous tumors showed loss of heterozygosity in broad regions on chromosome 13, with losses at all consecutive markers distal to Ptch1 locus (S-type). In contrast, all tumors that developed after 3 Gy irradiation exhibited interstitial losses around Ptch1 with distal markers retained (R-type). There was a clear dose-dependent increase in the proportion of R-type tumors within the intermediate dose range, indicating that the R-type change is a reliable radiation signature. Importantly, the incidence of R-type tumors increased significantly (P = 0.007) at a dose as low as 50 mGy. Integrated array-comparative genomic hybridization and expression microarray analyses demonstrated that expression levels of many genes around the Ptch1 locus faithfully reflected the signature-associated reduction in genomic copy number. Furthermore, 573 genes on other chromosomes were also expressed differently between S-type and R-type tumors. They include genes whose expression changes during early cerebellar development such as Plagl1 and Tgfb2, suggesting a recapitulation of gene subsets functioning at distinct developmental stages. These findings provide, for the first time, solid experimental evidence for a significant increase in cancer risk by low-dose radiation at diagnostic levels and imply that radiation-induced carcinogenesis accompanies both genomic and gene expression signatures.
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Affiliation(s)
- Yuka Ishida
- Department of Technical Support and Development, Fundamental Technology Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
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36
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Zhirnov VV, Khyzhnyak SV, Voitsitskiy VM. The effects of ultra-low dose β-radiation on the physical properties of human erythrocyte membranes. Int J Radiat Biol 2010; 86:499-506. [DOI: 10.3109/09553001003717167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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37
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Giovanetti A, Deshpande T, Basso E. Persistence of genetic damage in mice exposed to low dose of X rays. Int J Radiat Biol 2009; 84:227-35. [DOI: 10.1080/09553000801902166] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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38
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Mothersill C, Seymour C. Implications for environmental health of multiple stressors. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2009; 29:A21-A28. [PMID: 19454807 DOI: 10.1088/0952-4746/29/2a/s02] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Recent insights into the mechanisms underlying the biological effects of low dose effects of ionising radiation have revealed that similar mechanisms can be induced by chemical stressors in the environment. This means that interactions between radiation and chemicals are likely and that the outcomes following mixed exposures to radiation and chemicals may not be predictable for human health, by consideration of single agent effects. Our understanding of the biological effects of low dose exposure has undergone a major paradigm shift. We now possess technologies which can detect very subtle changes in cells due to small exposures to radiation or other pollutants. We also understand much more now about cell communication, systems biology and the need to consider effects of low dose exposure at different hierarchical levels of organisation from molecules up to and including ecosystems. Furthermore we understand, at least in part, some of the mechanisms which drive low dose effects and which perpetuate these not only in the exposed organism but also in its progeny and in certain cases, its kin. This means that previously held views about safe doses or lack of harmful effects cannot be sustained. The International Commission on Radiological Protection (ICRP) and all national radiation and environmental protection organisations have always accepted a theoretical risk and have applied the precautionary principle and the LNT (linear-non-threshold) model which basically says that there is no safe dose of radiation. Therefore even in the absence of visible effects, exposure of people to radiation is strictly limited. This review will consider the historical context and the new discoveries and will focus on evidence for emergent effects after mixed exposures to combined stressors which include ionising radiation. The implications for regulation of low dose exposures to protect human health and environmental security will be discussed.
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Affiliation(s)
- Carmel Mothersill
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
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39
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Asaithamby A, Chen DJ. Cellular responses to DNA double-strand breaks after low-dose gamma-irradiation. Nucleic Acids Res 2009; 37:3912-23. [PMID: 19401436 PMCID: PMC2709554 DOI: 10.1093/nar/gkp237] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
DNA double-strand breaks (DSBs) are a serious threat to genome stability and cell viability. Although biological effects of low levels of radiation are not clear, the risks of low-dose radiation are of societal importance. Here, we directly monitored induction and repair of single DSBs and quantitatively analyzed the dynamics of interaction of DNA repair proteins at individual DSB sites in living cells using 53BP1 fused to yellow fluorescent protein (YFP-53BP1) as a surrogate marker. The number of DSBs formed was linear with dose from 5 mGy to 1 Gy. The DSBs induced by very low radiation doses (5 mGy) were repaired with efficiency similar to repair of DSBs induced at higher doses. The YFP-53BP1 foci are dynamic structures: 53BP1 rapidly and reversibly interacted at these DSB sites. The time frame of recruitment and affinity of 53BP1 for DSB sites were indistinguishable between low and high doses, providing mechanistic evidence for the similar DSB repair after low- and high-dose radiation. These findings have important implications for estimating the risk associated with low-dose radiation exposure on human health.
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Affiliation(s)
| | - David J. Chen
- *To whom correspondence should be addressed. Tel: +1 214 648 5597; Fax: +1 214 648 5995;
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40
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Johnson KJ, Alexander BH, Doody MM, Sigurdson AJ, Linet MS, Spector LG, Hoffbeck W, Simon SL, Weinstock RM, Ross JA. Childhood cancer in the offspring born in 1921-1984 to US radiologic technologists. Br J Cancer 2008; 99:545-50. [PMID: 18665174 PMCID: PMC2527813 DOI: 10.1038/sj.bjc.6604516] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We examined the risk of childhood cancer (<20 years) among 105 950 offspring born in 1921-1984 to US radiologic technologist (USRT) cohort members. Parental occupational in utero and preconception ionising radiation (IR) testis or ovary doses were estimated from work history data, badge dose data, and literature doses (the latter doses before 1960). Female and male RTs reported a total of 111 and 34 haematopoietic malignancies and 115 and 34 solid tumours, respectively, in their offspring. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression. Leukaemia (n=63) and solid tumours (n=115) in offspring were not associated with maternal in utero or preconception radiation exposure. Risks for lymphoma (n=44) in those with estimated doses of <0.2, 0.2-1.0, and >1.0 mGy vs no exposure were non-significantly elevated with HRs of 2.3, 1.8, and 2.7. Paternal preconception exposure to estimated cumulative doses above the 95th percentile (82 mGy, n=6 cases) was associated with a non-significant risk of childhood cancer of 1.8 (95% CI 0.7-4.6). In conclusion, we found no convincing evidence of an increased risk of childhood cancer in the offspring of RTs in association with parental occupational radiation exposure.
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Affiliation(s)
- K J Johnson
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN 55455, USA
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41
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Lifestyle-related factors and environmental agents causing cancer: an overview. Biomed Pharmacother 2007; 61:640-58. [PMID: 18055160 DOI: 10.1016/j.biopha.2007.10.006] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Accepted: 10/10/2007] [Indexed: 02/09/2023] Open
Abstract
The increasing incidence of a variety of cancers after the Second World War confronts scientists with the question of their origin. In Western countries, expansion and ageing of the population as well as progress in cancer detection using new diagnostic and screening tests cannot fully account for the observed growing incidence of cancer. Our hypothesis is that environmental factors play a more important role in cancer genesis than it is usually agreed. (1) Over the last 2-3 decades, alcohol consumption and tobacco smoking in men have significantly decreased in Western Europe and North America. (2) Obesity is increasing in many countries, but the growing incidence of cancer also concerns cancers not related to obesity nor to other known lifestyle-related factors. (3) There is evidence that the environment has changed over the time period preceding the recent rise in cancer incidence, and that this change, still continuing, included the accumulation of many new carcinogenic factors in the environment. (4) Genetic susceptibility to cancer due to genetic polymorphism cannot have changed over one generation and actually favours the role of exogenous factors through gene-environment interactions. (5) Age is not the unique factor to be considered since the rising incidence of cancers is seen across all age categories, including children, and adolescents. (6) The fetus is specifically vulnerable to exogenous factors. A fetal exposure during a critical time window may explain why current epidemiological studies may still be negative in adults. We therefore propose that the involuntary exposure to many carcinogens in the environment, including microorganisms (viruses, bacteria and parasites), radiations (radioactivity, UV and pulsed electromagnetic fields) and many xenochemicals, may account for the recent growing incidence of cancer and therefore that the risk attributable to environmental carcinogen may be far higher than it is usually agreed. Of major concern are: outdoor air pollution by carbon particles associated with polycyclic aromatic hydrocarbons; indoor air pollution by environmental tobacco smoke, formaldehyde and volatile organic compounds such as benzene and 1,3 butadiene, which may particularly affect children and food contamination by food additives and by carcinogenic contaminants such as nitrates, pesticides, dioxins and other organochlorines. In addition, carcinogenic metals and metalloids, pharmaceutical medicines and some ingredients and contaminants in cosmetics may be involved. Although the risk fraction attributable to environmental factors is still unknown, this long list of carcinogenic and especially mutagenic factors supports our working hypothesis according to which numerous cancers may in fact be caused by the recent modification of our environment.
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Belpomme D, Irigaray P, Hardell L, Clapp R, Montagnier L, Epstein S, Sasco AJ. The multitude and diversity of environmental carcinogens. ENVIRONMENTAL RESEARCH 2007; 105:414-29. [PMID: 17692309 DOI: 10.1016/j.envres.2007.07.002] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 06/25/2007] [Accepted: 07/05/2007] [Indexed: 05/16/2023]
Abstract
We have recently proposed that lifestyle-related factors, screening and aging cannot fully account for the present overall growing incidence of cancer. In order to propose the concept that in addition to lifestyle related factors, exogenous environmental factors may play a more important role in carcinogenesis than it is expected, and may therefore account for the growing incidence of cancer, we overview herein environmental factors, rated as certainly or potentially carcinogenic by the International Agency for Research on Cancer (IARC). We thus analyze the carcinogenic effect of microorganisms (including viruses), radiations (including radioactivity, UV and pulsed electromagnetic fields) and xenochemicals. Chemicals related to environmental pollution appear to be of critical importance, since they can induce occupational cancers as well as other cancers. Of major concerns are: outdoor air pollution by carbon particles associated with polycyclic aromatic hydrocarbons; indoor air pollution by environmental tobacco smoke, formaldehyde and volatile organic compounds such as benzene and 1,3 butadiene, which may particularly affect children, and food pollution by food additives and by carcinogenic contaminants such as nitrates, pesticides, dioxins and other organochlorines. In addition, carcinogenic metals and metalloids, pharmaceutical medicines and cosmetics may be involved. Although the risk fraction attributable to environmental factors is still unknown, this long list of carcinogenic and especially mutagenic factors supports our working hypothesis according to which numerous cancers may in fact be caused by the recent modification of our environment.
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Affiliation(s)
- D Belpomme
- Department of Medical Oncology, European Hospital Georges Pompidou (HEGP), University of Paris, F-75015Paris, France.
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Erokhin VN, Krementsova AV, Semenov VA, Burlakova EB. Effect of antioxidant β-(4-hydroxy-3,5-ditertbutylphenyl)Propionic acid (phenosan) on the development of malignant neoplasms. BIOL BULL+ 2007. [DOI: 10.1134/s1062359007050111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Zytkovicz A, Daftari I, Phillips TL, Chuang CF, Verhey L, Petti PL. Peripheral dose in ocular treatments with CyberKnife and Gamma Knife radiosurgery compared to proton radiotherapy. Phys Med Biol 2007; 52:5957-71. [PMID: 17881812 DOI: 10.1088/0031-9155/52/19/016] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Peripheral radiation can have deleterious effects on normal tissues throughout the body, including secondary cancer induction and cataractogenesis. The aim of this study is to evaluate the peripheral dose received by various regions of the body after ocular treatment delivered with the Model C Gamma Knife, proton radiotherapy with a dedicated ocular beam employing no passive-scattering system, or a CyberKnife unit before and after supplemental shielding was introduced. TLDs were used for stray gamma and x-ray dosimetry, whereas CR-39 dosimeters were used to measure neutron contamination in the proton experiments. Doses to the contralateral eye, neck, thorax and abdomen were measured on our anthropomorphic phantom for a 56 Gy treatment to a 588 mm(3) posterior ocular lesion. Gamma Knife (without collimator blocking) delivered the highest dose in the contralateral eye, with 402-2380 mSv, as compared with 118-234 mSv for CyberKnife pre-shielding, 46-255 mSv for CyberKnife post-shielding and 9-12 mSv for proton radiotherapy. Gamma Knife and post-shielding CyberKnife delivered comparable doses proximal to the treatment site, with 190 versus 196 mSv at the thyroid, whereas protons doses at these locations were less than 10 mSv. Gamma Knife doses decreased dramatically with distance from the treatment site, delivering only 13 mSv at the lower pelvis, comparable to the proton result of 4 to 7 mSv in this region. In contrast, CyberKnife delivered between 117 and 132 mSv to the lower pelvis. In conclusion, for ocular melanoma treatments, a proton beam employing no double scattering system delivers the lowest peripheral doses proximally to the contralateral eye and thyroid when compared to radiosurgery with the Model C Gamma Knife or CyberKnife. At distal locations in the pelvis, peripheral doses delivered with proton and Gamma Knife are of an order of magnitude smaller than those delivered with CyberKnife.
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Affiliation(s)
- A Zytkovicz
- Department of Radiation Oncology, University of California-San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
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45
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Togashi K. Invited Commentary. Radiographics 2007. [DOI: 10.1148/radiographics.27.4.0270917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Matsumoto H, Hamada N, Takahashi A, Kobayashi Y, Ohnishi T. Vanguards of paradigm shift in radiation biology: radiation-induced adaptive and bystander responses. JOURNAL OF RADIATION RESEARCH 2007; 48:97-106. [PMID: 17327685 DOI: 10.1269/jrr.06090] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The risks of exposure to low dose ionizing radiation (below 100 mSv) are estimated by extrapolating from data obtained after exposure to high dose radiation, using a linear no-threshold model (LNT model). However, the validity of using this dose-response model is controversial because evidence accumulated over the past decade has indicated that living organisms, including humans, respond differently to low dose/low dose-rate radiation than they do to high dose/high dose-rate radiation. In other words, there are accumulated findings which cannot be explained by the classical "target theory" of radiation biology. The radioadaptive response, radiation-induced bystander effects, low-dose radio-hypersensitivity, and genomic instability are specifically observed in response to low dose/low dose-rate radiation, and the mechanisms underlying these responses often involve biochemical/molecular signals that respond to targeted and non-targeted events. Recently, correlations between the radioadaptive and bystander responses have been increasingly reported. The present review focuses on the latter two phenomena by summarizing observations supporting their existence, and discussing the linkage between them from the aspect of production of reactive oxygen and nitrogen species.
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Affiliation(s)
- Hideki Matsumoto
- Division of Oncology, Biomedical Imaging Research Center, University of Fukui, Eiheiji, Japan.
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Stavas JM, Smith TP, DeLong DM, Miller MJ, Suhocki PV, Newman GE. Radiation hand exposure during restoration of flow to the thrombosed dialysis access graft. J Vasc Interv Radiol 2007; 17:1611-7. [PMID: 17057002 DOI: 10.1097/01.rvi.0000236842.49430.bd] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To determine radiation dose to the hands of interventional radiologists during restoration of flow to thrombosed dialysis access grafts. MATERIALS AND METHODS Sixty-two procedures were performed in 54 patients with thrombosed synthetic arteriovenous hemodialysis access grafts. For each procedure, five staff interventional radiologists wore thermoluminescent ring dosimeters on each hand. Overall hand doses were obtained, and patient and graft factors as well as technical factors were analyzed to determine the effects on hand exposure. RESULTS The mean right hand and left hand exposures were 0.78 mSv and 0.55 mSv (78 and 55 mrem), respectively, and there was a significant difference between the two (P = .01). There was a significant difference among the interventionalists, mostly based on the lower doses associated with a single operator (P < .01). Not unexpectedly, fluoroscopy times (P < .01) and, to a lesser degree, the number of angiographic runs (P = .05) were significant factors influencing hand radiation dose. Patient sex, age and location of the graft, previous thrombosis, the number of previous interventions, and success or failure of the procedure were not significant factors in hand dose. CONCLUSIONS Hand exposure during the restoration of flow to thrombosed dialysis access grafts is relatively high and is greater for the right hand than for the left. The exposures are dependent on technical factors, most notably fluoroscopy times, not on patient- or graft-related factors.
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Affiliation(s)
- Joseph M Stavas
- Department of Radiology, Duke University Medical Center, Room 1502, Erwin Road, Durham, NC 27710, USA
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Takabatake T, Fujikawa K, Tanaka S, Hirouchi T, Nakamura M, Nakamura S, Braga-Tanaka I, Ichinohe K, Saitou M, Kakinuma S, Nishimura M, Shimada Y, Oghiso Y, Tanaka K. Array-CGH analyses of murine malignant lymphomas: genomic clues to understanding the effects of chronic exposure to low-dose-rate gamma rays on lymphomagenesis. Radiat Res 2006; 166:61-72. [PMID: 16808621 DOI: 10.1667/rr3575.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We previously reported that mice chronically irradiated with low-dose-rate gamma rays had significantly shorter mean life spans than nonirradiated controls. This life shortening appeared to be due primarily to earlier death due to malignant lymphomas in the irradiated groups (Tanaka et al., Radiat. Res. 160, 376-379, 2003). To elucidate the molecular pathogenesis of murine lymphomas after low-dose-rate irradiation, chromosomal aberrations in 82 malignant lymphomas from mice irradiated at a dose rate of 21 mGy/day and from nonirradiated mice were compared precisely by microarray-based comparative genomic hybridization (array-CGH) analysis. The array carried 667 BAC clones densely selected for the genomic regions not only of lymphoma-related loci but also of surface antigen receptors, enabling immunogenotyping. Frequent detection of the apparent loss of the Igh region on chromosome 12 suggested that most lymphomas in both groups were of B-cell origin. Array-CGH profiles showed a frequent gain of whole chromosome 15 in lymphomas predominantly from the irradiated group. The profiles also demonstrated copy-number imbalances of partial chromosomal regions. Partial gains on chromosomes 12, 14 and X were found in tumors from nonirradiated mice, whereas losses on chromosomes 4 and 14 were significantly associated with the irradiated group. These findings suggest that lymphomagenesis under the effects of continuous low-dose-rate irradiation is accelerated by a mechanism different from spontaneous lymphomagenesis that is characterized by the unique spectrum of chromosomal aberrations.
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Affiliation(s)
- Takashi Takabatake
- Department of Radiobiology, Institute for Environmental Sciences, 2-121, Hacchazawa, Takahoko, Rokkasho, Aomori 039-3213, Japan
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Batra V, Kesavan V, Mishra KP. Modification of p53 protein profile by gamma irradiation followed by methyl donor starvation. Mol Cell Biochem 2006; 293:15-21. [PMID: 16767497 DOI: 10.1007/s11010-006-1170-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2005] [Accepted: 07/20/2005] [Indexed: 10/24/2022]
Abstract
The possible beneficial radio-protective effects of one-carbon transfer agents namely folate, choline and methionine have been the subject of extensive investigation. Ionizing radiation is known to extensively damage the DNA. One-carbon transfer agents have been proposed to have important role in context of DNA repair via their role in purine and thymidylate synthesis and in DNA methylation. Sufficient dietary availability of one-carbon transfer agents therefore, might have ability to modify radiation effects. In present study modifications in level of tumor suppressor protein p53 by gamma irradiation followed by methyl donor starvation was observed. Experiments showed an increase in nuclear and cytoplasmic p53 protein concentration in liver, spleen and thymus. The overall rise in the level of p53 protein in liver was found to be less than that in spleen and thymus. Moreover significant heterogeneity in the basal level of expression of the p53 protein in liver, spleen and thymus was observed as the level of p53 protein in spleen and thymus was found to be 7-8 fold more than that in liver. Results indicated that radiation stress followed by methyl donor starvation could significantly induce p53 protein in spleen and thymus where there was a dramatic accumulation of p53 following irradiation, while in other tissues, particularly the liver, no such dramatic response was seen. Folate contribution of intestinal bacteria was found to influence p53 protein levels. Our observations indicated a prominent role played by the methyl donors in protecting the cell against harmful effects of ionizing radiation.
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Affiliation(s)
- Vipen Batra
- Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre, Modular Laboratories, Room No. 3-47-S, Mumbai-400 085, India
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Ovadia D, Bar-On E, Fragnière B, Rigo M, Dickman D, Leitner J, Wientroub S, Dubousset J. Radiation-free quantitative assessment of scoliosis: a multi center prospective study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2006; 16:97-105. [PMID: 16705434 PMCID: PMC2198878 DOI: 10.1007/s00586-006-0118-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2005] [Revised: 02/15/2006] [Accepted: 02/22/2006] [Indexed: 10/24/2022]
Abstract
Accurate quantitative measurements of the spine are essential for deformity diagnosis and assessment of curve progression. There is much concern related to the multiple exposures to ionizing radiation associated with the Cobb method of radiographic measurement, currently the standard procedure for diagnosis and follow-up of the progression of scoliosis. In addition, the Cobb method relies on 2-D analysis of a 3-D deformity. The aim of this prospective study was to investigate the clinical value of Ortelius800 that provides a radiation-free method for scoliosis assessment in three planes (coronal, sagittal, apical), with simultaneous automatic calculation of the Cobb angle in both coronal and sagittal views. Analysis of the clinical value of the device for assessing spinal deformities was performed on patients with adolescent idiopathic scoliosis, deformity angles ranging from 10 degrees to 48 degrees. Correlation between Cobb angles measured manually on standard erect posteroanterior radiographs and those calculated by Ortelius800 showed an absolute difference between the measurements to be significantly less than +/- 5 degrees for coronal measurements and significantly less than +/- 6 degrees for sagittal measurements indicating good correlation between the two methods. The measurements from four independent sites and six independent examiners were not significantly different. We found the novel clinical tool to be reliable for following mild and moderate idiopathic curves in both coronal and sagittal planes, without exposing the patient to ionizing radiation. Considering the need for further validation of this new method, any change in treatment protocol should still be based on radiographic control.
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Affiliation(s)
- Dror Ovadia
- Department of Pediatric Orthopaedics, Dana Children's Hospital-Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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