Gamma and Beta Absorbed Dose Conversion Coefficients in the Range from 10 keV to 10 MeV for Accidental Exposures From Point Sources Placed in Clothing in Proximity to the Body.

Retrospective dose assessment following acute radiation exposures during radiological incidents can be difficult and inaccurate due to the large uncertainties associated with dose estimation. However, rapid and accurate dose assessment is critical following an incident so that appropriate treatment can be provided to the patient as early as possible. Incident dose assessment relies heavily on biological dosimetry with corresponding large uncertainties for inhomogeneous exposures, resulting from the estimates of whole-body doses, while the assessment of absorbed doses to individual tissues might actually be more appropriate for acute radiation exposures. Incident exposure scenarios for orphan sources placed in a breast or back pants pocket were modeled using the International Commission on Radiological Protection computational reference male and female and the Monte Carlo N-particle code MCNP6 to compute absorbed dose conversion coefficients for organs of interest for monoenergetic photon and beta sources. The absorbed dose conversion coefficients are intended for use in conjunction with source information to rapidly estimate absorbed doses to organs of interest from radiological sources in one of the two pocket geometries. Absorbed dose conversion coefficients also have been calculated specifically for Co, Cs, and Ir. Those absorbed dose conversion coefficients were applied to data from a radiological incident in Yanango, Peru, for comparison with published dose assessments; the results agree within 20%. The conversion coefficients are expected to provide an accurate tool for assessing doses for the modeled geometries, provided uncertainties due to the exact source-body geometry and exposure time are considered.

A BRIEF OVERVIEW OF COMPARTMENTAL MODELING FOR INTAKE OF PLUTONIUM VIA WOUNDS.

The aim of this study is to present several approaches that have been used to model the behavior of radioactive materials (specifically Pu) in contaminated wounds. We also review some attempts by the health physics community to validate and revise the National Council on Radiation Protection and Measurements (NCRP) 156 biokinetic model for wounds, and present some general recommendations based on the review. Modeling of intake via the wound pathway is complicated because of a large array of wound characteristics (e.g. solubility and chemistry of the material, type and depth of the tissue injury, anatomical location of injury). Moreover, because a majority of the documented wound cases in humans are medically treated (excised or treated with chelation), the data to develop biokinetic models for unperturbed wound exposures are limited. Since the NCRP wound model was largely developed from animal data, it is important to continue to validate and improve the model using human data whenever plausible.

Evaluation of Reference Urinary Excretion Concentrations of Selected Radionuclides Corresponding to Clinical Decision Guides for Application in Radiological and in Nuclear Emergencies.

Radiological or nuclear emergency situations could lead to incorporation of radionuclides by the population. Intakes of radionuclides can be evaluated through measurements of radionuclides present in organs and tissues, or in urinary and/or fecal excretion. In an emergency situation involving a large number of people, the decision to provide medical treatment to an individual will likely be based on a single measurement. For that purpose, the National Council on Radiation Protection and Measurements (NCRP) has presented the Clinical Decision Guide (CDG) quantity, which corresponds to an intake amount of a radionuclide by an individual for which treatment is recommended. However, the NCRP recommends using one-fifth of the CDG for pregnant women and children which could result in an effective or equivalent dose in excess of the dose constraint. Tables of reference urinary excretion concentrations which are associated with an intake of one CDG for inhalation and ingestion intake scenarios of several forms of 60Co, 90Sr, 137Cs, 192Ir, 238Pu, 239Pu and 241Am have been calculated and are presented for the following categories of members of the public: 3 months old, 1 y, 5 y, 10 y, 15 y, adult and pregnant woman.

Efficacy of Prussian blue on 137Cs decorporation therapy.

Prussian blue (PB) is an efficient drug for enhancing cesium elimination from the body. Literature data on the efficacy of PB treatment in dosages that vary from 1-10 g d was reviewed. Cesium biokinetics was simulated using a detailed systemic biokinetic model. The same model was used to simulate the maximum action of PB by interrupting the enterohepatic circulation. Model results reproduced reasonably well the literature data on the efficacy of PB administered to humans after incidental cesium intakes, as well as results from animal experiments. Maximum efficiency of the reduction of the long-term half-time is obtained with the administration of 3 g d PB to the adult. Maximum efficiency of reducing the Cs body burdens is obtained when PB is administered on the first day after the intake, due to the increase of the short-term elimination of cesium. The model predicts that reduction of the long-term half-life is not affected by the time after intake that PB is administered, as long as it is given within the interval from 1 h to 1 y after the intake.

Idiopathic pulmonary haemosiderosis in a child with Down's syndrome: case report and review of the literature.

We report the case of a female child with Down's syndrome affected by idiopathic pulmonary haemosiderosis (IPH), who was successfully treated with hydroxychloroquine. First-line conventional treatment of IPH is traditionally based on systemic corticosteroids; however, many steroid-sparing agents are being increasingly used as adjuncts to corticosteroids in children with recurrent or refractory bleeding. The use of these drugs is particularly promising for maintenance treatment, because it tends to avoid the adverse effects of long-term corticosteroids.

Dose coefficients for intakes of radionuclides via contaminated wounds.

The NCRP Wound Model, which describes the retention of selected radionuclides at the site of a contaminated wound and their uptake into the transfer compartment, has been combined with the ICRP element-specific systemic models for those radionuclides to derive dose coefficients for intakes via contaminated wounds. These coefficients can be used to generate derived regulatory guidance (i.e., the activity in a wound that would result in an effective dose of 20 or 50 mSv, or in some cases, a organ-equivalent dose of 500 mSv) and clinical decision guidance (i.e., activity levels that would indicate the need for consideration of medical intervention to remove activity from the wound site, administration of decorporation therapy or both). Data are provided for 38 radionuclides commonly encountered in various activities such as nuclear weapons, fuel fabrication or recycling, waste disposal, medicine, research, and nuclear power. These include 3H, 14C, 32P, 35S, 59Fe, 57,58,60Co, 85,89,90Sr, 99mTc, 106Ru, 125,129,131I, 134,137Cs, 192Ir, 201Tl, 210Po, 226,228Ra, 228,230,232Th, 234,235,238U, 237Np, 238,239,240,241Pu, 241Am, 242,244Cm, and 252Cf.

[Acute respiratory stridor in infancy]. / Stridore respiratorio ingravescente nella prima infanzia.

Infantile subglottic hemangioma is a pediatric tumor of endothelial cells characterized by an initial phase of rapid proliferation (around 6 months), followed by slow involution, often leading to complete regression following the first year of life. It is most frequently found in females and it usually it occurs also in the skin. From its position it can cause a progressive airway obstruction, so early diagnosis and treatment are very important. Many treatments have been described in the literature, including systemic steroids, intralesional steroid injection, carbon dioxide laser therapy, submucous resection, interferon alfa-2 and also tracheostomy as last approach. This case report discusses a 6-month old infant, that arrived to our attention for an acute two-way stridor. Laringoscopy under general anesthesia showed a subocclusive subglottic haemangioma that closed 70% of the laryngeal airway. In agreement with our ENT specialist it was decided to begin systemic steroid therapy, first by i.v. ingection during intensive therapy with rinotracheal intubation and mechanic ventilation; after the canula removal and the hemangioma reduction, the patient took oral steroids with a gradual reduction of the dose. This case evidences the importance of laryngoscopy in the diagnosis of subglottic haemangioma; it also proves the importance of multi-disciplinary collaboration with ENT specialist and dermatologist for the diagnosis and treatment of this kind of patient. It also shows that systemic steroids are an effective alternative in the management of obstructive pediatric subglottic hemangiomas.

Uncertainties in internal doses calculated for Mayak workers--a study of 63 cases.

This study makes use of 63 cases of Mayak workers exposed to Pu-239 with autopsy data and some late-time urine bioassay data. In addition, air-concentration data--used to construct monthly average values--are available for each case, which provide the time dependence and potential magnitudes of normal inhalation intakes for each case. The purpose of the study is to develop and test Bayesian methods of dose calculation for the Mayak workers. The first part of the study was to quantitatively characterise the uncertainties of the bioassay data. Then, starting with three different published biokinetic models, the data are fit by varying intake and model perturbation parameters, e.g., parameters influencing the lung, thoracic lymph nodes, liver and bone retention. Statistical self-consistency arguments are used to check the measurement uncertainty parameters within the Poisson-lognormal model. The second part of the study is to set up and test Bayesian dose calculations, which use the point determinations of biokinetic parameters from the study cases within a discrete, empirical Bayes approximation. The main conclusion of the study is that these methods are now ready to be applied to the entire Mayak worker population.

IMPDOS (improved dosimetry and risk assessment for plutonium-induced diseases): internal dosimetry software tools developed for the Mayak worker study.

A collection of software tools developed for the Mayak worker study is described. IMPDOS is software for modelling, data analysis, and activity and dose calculations using the bioassay and postmortem data from Mayak workers provided by Southern Urals Biophysics Institute. The capabilities include: parameter fitting of data for individual cases, Bayesian dose calculations using the fit results for collections of cases with extensive data as a biokinetic prior, and database storage of results for retrieval, analysis and interpretation.

A study of early Los Alamos internal exposures to plutonium.

Internal dose caused by exposure to (239)Pu/(240)Pu is calculated for a group of 210 former Los Alamos workers who participated in the urine bioassay programme during the years 1944-45. An iterative Bayesian procedure is employed, where the distribution of intake amounts resulting from an initial calculation is used to define a prior probability distribution of inhalation intakes for an iterated second calculation. The urine bioassay data from this time period were not of high quality, and the more accurate intake prior tempers the effect of spurious high samples, which were probably caused by sample contamination.

An empirical multivariate log-normal distribution representing uncertainty of biokinetic parameters for 137Cs.

A simplified biokinetic model for (137)Cs has six parameters representing transfer of material to and from various compartments. Using a Bayesian analysis, the joint probability distribution of these six parameters is determined empirically for two cases with quite a lot of bioassay data. The distribution is found to be a multivariate log-normal. Correlations between different parameters are obtained. The method utilises a fairly large number of pre-determined forward biokinetic calculations, whose results are stored in interpolation tables. Four different methods to sample the multidimensional parameter space with a limited number of samples are investigated: random, stratified, Latin Hypercube sampling with a uniform distribution of parameters and importance sampling using a lognormal distribution that approximates the posterior distribution. The importance sampling method gives much smaller sampling uncertainty. No sampling method-dependent differences are perceptible for the uniform distribution methods.

AIDE: internal dosimetry software.

AIDE (Activity and Internal Dose Estimates) is a software for calculating activities in compartments and committed doses due to occupational exposures, and for performing intake and dose estimates using bioassay data. It has been continuously developed and tested for more than 20 years. Its calculation core has been applied in several situations, like performing all dose estimates due to (137)Cs intakes, which occurred during the Goiania accident in 1987; performing quality assurance of the ICRP Task Group on Dose Calculations regarding calculations of activities in compartments and generation of dose coefficients for adults due to intakes by inhalation, ingestion and injection of several radionuclides; and producing the tables of activities in compartments and dose coefficients using the NCRP Wound Model for the NCRP report. It provides several capabilities like performing calculations using modified Human Respiratory Tract Model parameters for the mechanical transport, blood absorption and partitions of deposit in the AI region. The existing systemic models can also be modified or new ones can be entered. All estimate procedures are in accordance with the methods presented in the ICRP-78 Publication, in the IAEA Safety Reports Series no. 37 and in the IDEAS Project Guidelines 2006.

Bayesian hypothesis testing-use in interpretation of measurements.

Bayesian hypothesis testing may be used to qualitatively interpret a dataset as indicating something "detected" or not. Hypothesis testing is shown to be equivalent to testing the posterior distribution for positive true amounts by redefining the prior to be a mixture of the original prior and a delta-function component at 0 representing the null hypothesis that nothing is truly present. The hypothesis-testing interpretation of the data is based on the posterior probability of the usual modeling hypothesis relative to the null hypothesis. Real numerical examples are given and discussed, including the distribution of the non-null hypothesis probability over 4,000 internal dosimetry cases. Currently used comparable methods based on classical statistics are discussed.

Comparison of dose estimation from occupational exposure to 239Pu using different modelling approaches.

Several approaches are available for bioassay interpretation when assigning Pu doses to Mayak workers. First, a conventional approach is to apply ICRP models per se. An alternative method involves individualised fitting of bioassay data using Bayesian statistical methods. A third approach is to develop an independent dosimetry system for Mayak workers by adapting ICRP models using a dataset of available bioassay measurements for this population. Thus, a dataset of 42 former Mayak workers, who died of non-radiation effects, with both urine bioassay and post-mortem tissue data was used to test these three approaches. All three approaches proved to be adequate for bioassay and tissue interpretation, and thus for Pu dose reconstruction purposes. However, large discrepancies are observed in the resulting quantitative dose estimates. These discrepancies can, in large part, be explained by differences in the interpretation of Pu behaviour in the lungs in the context of ICRP lung model. Thus, a careful validation of Pu lung dosimetry model is needed in Mayak worker dosimetry systems.

Internal dose assessment data management system for a large population of Pu workers.

This paper describes the design and implementation of the Los Alamos National Laboratory (LANL) dose assessment (DA) data system. Dose calculations for the most important radionuclides at LANL, namely plutonium, americium, uranium and tritium, are performed through the Microsoft Access DA database. DA includes specially developed forms and macros that perform a variety of tasks, such as retrieving bioassay data, launching the FORTRAN internal dosimetry applications and displaying dose results in the form of text summaries and plots. The DA software involves the following major processes: (1) downloading of bioassay data from a remote data source, (2) editing local and remote databases, (3) setting up and carrying out internal dose calculations using the UF code or the ID code, (3) importing results of the dose calculations into local results databases, (4) producing a secondary database of 'official results' and (5) automatically creating and e-mailing reports. The software also provides summary status and reports of the pending DAs, which are useful for managing the cases in process.

Worldwide bioassay data resources for plutonium/americium internal dosimetry studies.

Biokinetic models are the scientific underpinning of internal dosimetry and depend, ultimately, for their scientific validation on comparisons with human bioassay data. Three significant plutonium/americium bioassay databases, known to the authors, are described: (1) Sellafield, (2) Los Alamos and (3) the United States Transuranium Registry. A case is made for a uniform standard for database format, and the XML standard is discussed.

Internal dosimetry verification and validation database.

Simulated-data internal dosimetry cases for use in intercomparison exercises or as a software verification and validation tool have been published on the internet (www.lanl.gov/bayesian/software Bayesian software package II). A user may validate their internal dosimetry code or method using this simulated bioassay data. Or, the user may choose to try out the Los Alamos National Laboratory codes ID and UF, which are also supplied. A Poisson-lognormal model of data uncertainty is assumed. A collection of different possible models for each nuclide (e.g. solubility types and particle sizes) are used. For example, for 238Pu, 14 different biokinetic models or types (8 inhalation, 4 wound and 2 ingestion) are assumed. Simulated data are generated for all the assumed biokinetic models, both for incidents, where the time of intake is known, and for non-incidents, where it is not. For the dose calculations, the route of intake, but not the biokinetic model, is considered to be known. The object is to correctly calculate the known true dose from simulated data covering a period of time. A 'correct' result has been defined in two ways: (1) that the credible limits of the calculated dose include the correct dose and (2) that the calculated dose is within a factor of 2 of the correct dose.

Vertical hepatitis C virus transmission is not related to mother-child class-1 HLA concordance.

Mother-child human leukocyte antigen (HLA)diversity is protective for vertical transmission of some viruses. The aim of this study is to evaluate the role of mother-child HLA diversity on hepatitis C virus (HCV) vertical transmission. Forty consecutive HCV infected and 46 consecutive control uninfected children born to HCV-RNA positive mothers were evaluated for HLA class-1 type concordance with their mothers. No significant difference in the degree of HLA concordance was found between HCV infected and uninfected children both when A, B, C (p=0.30) and when only A and B alleles were evaluated (p=0.59). Mother-infant HLA concordance does not affect HCV vertical transmission.

Substituted 1,2,3-triazolo[1,5-a]quinazolines: synthesis and binding to benzodiazepine and adenosine receptors.

This paper reports the synthesis and evaluation of the biological affinity towards benzodiazepine and A(1) and A(2A) adenosine receptors of some 3-ethoxycarbonyl or 3-phenyl-substituted 1,2, 3-triazolo[1,5-a]quinazolines. Starting from the appropriate chloro-substituted phenylazides, the series of 7 or 8 chloro-substituted triazoloquinazolines were prepared. Nitration reactions of the triazoloquinazoline ring and chlorination reactions of the hydroxyl group in the 5 position of the same ring are also reported. By nucleophilic displacement of halogen, the corresponding 5-amino derivatives and some analogous derivatives bearing cyclohexylamino and p-toluidino substituents were obtained. The binding assays showed a generalized decrease in the affinity towards the benzodiazepine receptors and confirmed a moderate affinity towards the A(1) adenosine receptors in comparison with the previously studied triazoloquinazoline derivatives.