The exposure of the German population to man-made radiation results mainly from diagnostic X-ray and nuclear medical examinations. Data are presented about the annual frequency and the average dose of the various examination types for West Germany in the years 1990-1992. According to these data a yearly average of approximately 1550 diagnostic examinations using ionizing radiation were performed per 1000 inhabitants resulting in an annual per caput effective dose of 1.9 mSv. Despite the frequent use of alternative examination techniques, such as sonography, nuclear magnetic resonance and endoscopy, the frequency of X-ray and nuclear medical examinations is still increasing. If collective risk assessments are done using the per caput effective dose, at least the age distribution of the patients must be considered. This leads to a "risk-modifying factor" of 0.6-0.7 for patients to be applied to the ICRP risk coefficient of 5 % per Sv valid for the general population. However, radiation risk must always be viewed in context with disease- and therapy-related risks and balanced against the benefit of the diagnostic examination, which should always exceed the risk for a well-indicated procedure.
Absorbed doses to the liver, spleen, red marrow, lungs, kidneys, and to various parts of bone tissue were calculated for long-term burdens of intravascularly injected Thorotrast. The estimates were performed for typical injection levels of 10, 30, 50 and 100 ml, based upon "best estimates" of =?h tissue distribution, and steady state activity ratios between the subsequent daughters.Correcting for the a-particle self absorption within Thorotrast aggregates, the mean or-ray dose to a standard 70-kg man at 30 yr after the injection of 25 ml of Thorotrast is 750rad to the liver, 2100rad to the spleen, 270rad to the red marrow, 60-620rad in various parts of the lung, and 13 rad to the kidneys. Dose rates to various parts of bone tissue (bone surface, compact, and cancellous bone) were estimated by applying the ICRP model on alkaline earth metabolism to the continuous translocation of thorium daughters to bone and to the formation of thorium daughters by decay within bone tissue. The average dose to calcified bone from translocated *"Ra with its daughters is 18 rad at 30 yr after the injection of 25 ml of Thorotrast. Considering the Spiess-Mays risk coefficient of 0.9-1.7% bone sarcoma/lOO rad of average skeletal dose from 224Ra and its daughters, the induction of 1.6-3.1 bone sarcomas per lo00 Thorotrast patients is predicted.
Radiation carcinogenesis/alpha-irradiation/Thorotrast/Th-232The intravascular injection of the formerly used contrast medium Thorotrast -a colloidal suspension of thoriumdioxide causes a chronic exposure to a-particles especially in the organs of the reticuloendothelial system. The German Thorotrast Study comprises 2326 Thorotrast patients and 1890 contemporary matched patients in the control group to be evaluated. 899 Thorotrast patients and 662 controls had clinical and biophysical follow-up examinations every two years since 1969. The recent most important results of the study are: A high excess rate of primary liver cancer (410/2) was observed beginning after the 15th year of exposure. 31% of the tumors are combined with cirrhosis and 6% with other neoplastic diseases. A clear (mean) dose rate effect relationship exists. The tumor frequency depends on the time of exposure or the cumulative dose to the liver respectively and not primarily on the age at injection. The lowest cumulative doses at 10 years before diagnosis of liver cancer were about 2 Gy. Risk estimates for liver cancer after 40 years of exposure are 500 malignant tumors per 104 person-Gy for men and 300 for women.A high excess rate exists also for leukaemias (excluding CLL) starting already 5 years after Thorotrast injection (39/4). The lowest cumulative doses to the red bone marrow at time of death were about 0.5 Gy. According to the present result, an excess rate can be expected for carcinomas of the extrahepatic bile ducts, pancreas, oesophagus, larynx, as well as Non-Hodgkin's lymphomas, bone sarcomas, plasmacytomas and mesotheliomas.
Background: Typically developing infants track moving objects with eye and head movements in a smooth and predictive way at 4 mo of age, but this ability is delayed in very preterm infants. We hypothesized that visual tracking ability in very preterm infants predicts later neurodevelopment. Method: In 67 very preterm infants (gestational age<32 wk), eye and head movements were assessed at 4 mo corrected age while the infant tracked a moving object. Gaze gain, smooth pursuit, head movements, and timing of gaze relative the object were analyzed off line. Results of the five subscales included in the Bayley Scales of Infant Development (BSID-III) at 3 y of age were evaluated in relation to the visual tracking data and to perinatal risk factors. results: Significant correlations were obtained between gaze gain and cognition, receptive and expressive language, and fine motor function, respectively, also after controlling for gestational age, severe brain damage, retinopathy of prematurity, and bronchopulmonary dysplasia. conclusion: This is the first study demonstrating that the basic ability to visually track a moving object at 4 mo robustly predicts neurodevelopment at 3 y of age in children born very preterm.
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