EFFECTIVE DOSE MEASUREMENT FOR CONE BEAM COMPUTED TOMOGRAPHY USING GLASS DOSIMETER

During image-guided radiation therapy, the patient is exposed to unwanted radiation from imaging devices built into the medical LINAC. In the present study, the effective dose delivered to a patient from a cone beam computed tomography (CBCT) machine was measured. Absorbed doses in specific organs listed in ICRP Publication 103 were measured with glass dosimeters calibrated with kilovolt (kV) X-rays using a whole body physical phantom for typical radiotherapy sites, including the head and neck, chest, and pelvis. The effective dose per scan for the head and neck, chest, and pelvis were 3.37±0.29, 7.36±0.33, and 4.09±0.29 mSv, respectively. The results highlight the importance of the compensation of treatment dose by managing imaging dose

Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohort

Objective: This study evaluated the efficacy of antithyroid drugs (ATDs) and risk factors associated with the recurrence of Graves’ hyperthyroidism using a comprehensive retrospective cohort. Methods: We included 1829 patients newly diagnosed with Graves’ hyperthyroidism, with sufficient follow-up data. Clinical outcomes of the patients and risk factors associated with recurrence-free survival, including the changes in thyrotropin receptor antibody, were evaluated. Results: The median age of the patients was 44.5 years, and 69% were female. Among the patients, 1235 had a chance to withdraw ATD after a median of 23 (interquartile range (IQR) 17.0–35.5) months of treatment. The first remission rate was 55.6% during a median of 72.7 months of follow-up. After the first recurrence, 95% of patients underwent the second course of ATD treatment for a median of 21 .1 (IQR 14.8–31.7) months, and the remission rate was 54.1%. During a median of 67 months of follow-up, 7.7% of patients underwent surgery, and 10.5% underwent radioac tive iodine therapy. Approximately 30% were still on ATD therapy for recurrent disease or prolonged lowdose maintenance. Younger age (<45 years), male sex, and fluctua ting or smoldering of TRAb levels were independent risk factors of the first recurrenc e after ATD treatment. Conclusions: ATD treatment is an acceptable option for the initial treatment of Graves’ hyperthyroidism as well as for recurrent disease. The optimal treatment period for ATD treatment needs to be determined using the individual risk factors of recurrence

Eosinophilic gastroenteritis in an 18-year-old male with prolonged nephrotic syndrome

Eosinophilic gastroenteritis is a rare disease characterized by prominent eosinophilic tissue infiltration of the gastrointestinal tract. Here, we report a case of eosinophilic gastroenteritis in an 18-year-old patient with prolonged nephrotic syndrome who presented with abdominal pain and peripheral hypereosinophilia. During the previous 2 years, he had visited local Emergency Department several times because of epigastric pain and nausea. He had been treated with steroid-dependent nephrotic syndrome since 3 years of age. Tests ruled out allergic and parasitic disease etiologies. Gastroduodenoscopy with biopsy revealed marked eosinophilic infiltration in the duodenum. Renal biopsy findings indicated minimal change disease spectrum without eosinophilic infiltration. The oral deflazacort dosage was increased, and the patient was discharged after abdominal pain resolved. To our knowledge, this is the first report of eosinophilic gastroenteritis in a patient with minimal change disease