RESUMO
Adult-onset Still's disease (AOSD) can progress into macrophage activation syndrome (MAS), which may be fatal. We report on a 19-year-old Han Chinese female, who presented with MAS-related pulmonary parenchymal involvement complicating AOSD, and further associated with disseminated intravascular coagulation and generalized tonic-clonic seizure. She was managed by high-dose corticosteroids and pulse cyclophosphamide therapy with a complete recovery of disease activity.
Assuntos
Ciclofosfamida/administração & dosagem , Coagulação Intravascular Disseminada , Glucocorticoides/administração & dosagem , Pneumopatias , Síndrome de Ativação Macrofágica , Convulsões , Doença de Still de Início Tardio/complicações , Coagulação Intravascular Disseminada/diagnóstico , Coagulação Intravascular Disseminada/tratamento farmacológico , Coagulação Intravascular Disseminada/etiologia , Relação Dose-Resposta a Droga , Feminino , Humanos , Imunossupressores/administração & dosagem , Pneumopatias/diagnóstico , Pneumopatias/tratamento farmacológico , Pneumopatias/etiologia , Síndrome de Ativação Macrofágica/sangue , Síndrome de Ativação Macrofágica/tratamento farmacológico , Síndrome de Ativação Macrofágica/etiologia , Síndrome de Ativação Macrofágica/fisiopatologia , Pulsoterapia , Convulsões/diagnóstico , Convulsões/tratamento farmacológico , Convulsões/etiologia , Resultado do Tratamento , Adulto JovemRESUMO
A series of dosimetric measurements was carried out at the Antoni van Leeuwenhoek Hospital, Amsterdam, using a Philips d + T generator, which produced neutrons with energies of approximately 14 MeV. A-150 plastic ionization chambers, an A-150 plastic calorimeter, and a GM dosimeter were used to determine total absorbed dose and the photon absorbed dose fraction. The ion chambers were calibrated in a 60Co gamma-ray field in air and compared in a phantom placed in the 60Co gamma-ray beam. Comparison of the total absorbed dose derived from the ionization chamber measurements to that determined using the calorimeter indicated agreement for the neutron measurements between the techniques to within +/- 2%.
Assuntos
Nêutrons Rápidos , Nêutrons , Monitoramento de Radiação , Radioterapia , Calorimetria , Transferência de Energia , Raios gama , Modelos Biológicos , Monitoramento de Radiação/métodos , Radioterapia/métodos , Dosagem RadioterapêuticaRESUMO
In the U.S. neutron radiotherapy trial centers, absorbed dose is routinely measured using commercially available A-150 tissue equivalent (TE) plastic ionization chambers. The collecting volumes of these chambers are filled with either methane-based tissue equivalent gas or air. Absorbed dose in A-150 plastic, determined with these ionization chambers, was compared to that measured by an A-150 plastic calorimeter in an A-150 plastic phantom. These comparisons have yielded the following information: (1) Agreement of the total absorbed dose measured using the ionization chambers was within 2.5% of the calorimeter at all the centers visited to date. (2) For all the neutron fields measured, the product of the stopping power ratio (sw,g)N' between the A-150 plastic chamber wall and TE gas, and the average energy expended in the gas per ion pair formed, WN/e, was computed assuming Bragg-Gray theory and found to be 31.0 +/- 0.7 J/C. (3) The displacement correction factor employed to normalize measurements at a depth in a phantom using the type IC-17 ionization chamber was verified to be approximately 0.97 +/- 0.01.