History and Organizations for Radiological Protection

Summary of radiation dose management and optimization: comparison of radiation protection measures between Poland and other countries

The purpose of this study is to show the actual recommendations for dose management and provide an overview of the available options for dose tracking and dose optimization. The legal institutions that supervise the radiological exposure of patients and their most important directives are presented. A literature review of existing diagnostic reference levels for computed tomography (CT), interventional radiology, radiography, paediatric radiography, mammography, and fluoroscopy in Europe and Poland was carried out. It has been shown that, in Poland, it is necessary to verify and determine the new diagnostic reference levels (DRLs) for each imaging modality because the existing ones are adapted from other countries and are not determined on the basis of data from Polish hospitals. They have not been updated for 11-17 years, although it is recommended to update them every 3-5 years. Many countries in Europe have already determined DRLs based on the analysis of their own dosage data (e.g. Austria and Germany). Analysing the existing DRLs for CT in Poland, it was noticed that they concern only a single anatomical region. It is necessary to determine the DRLs for multi-region CT (i.e. chest-abdomen-pelvis and neck-chest-abdomen-pelvis) examinations because these examinations account for about 60% of all oncological CT examinations-based on data collected from The Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw.

Radial vs. Dorsal Approach for Elastic Stable Internal Nailing in Pediatric Radius Fractures—A 10 Year Review

Background: Forearm fractures are one of the most common fractures in children. Over the last years, a tendency towards surgical treatment was seen, especially closed reduction and internal fixation with elastic stable internal nailing (ESIN). Despite an overall low complication rate being described, a risk of intraoperative complications remains. Material and Methods: A total of 237 patients (mean age 8.3 ± 3.4 (1–16) years) with forearm or radius fractures treated with ESIN between 2010 and 2020 were included in the study. The retrospective review of 245 focused on fracture pattern, pre- and postoperative fracture angulation, intra- and postoperative complications, and surgical approach for nail implant. The fracture pattern and pre- and postoperative angulation were measured radiographically. Complications such as ruptures of the extensor pollicis longus (EPL) tendon and sensibility disorders of the superficial radial nerve were further analyzed. Results: In 201 cases (82%), we performed a dorsal approach; 44 fractures (17.9%) were treated with a radial approach. In total, we found 25 (10%) surgery-related complications, of which 21 (8.6%) needed further surgical treatment. In total, we had 14 EPL ruptures (5.7%), 4 sensibility disorders of the superficial radial nerve (1.6%), 2 refractures after implant removal (0.8%), 2 superficial wound infections (0.8%), and 1 child with limited range of motion after surgery (0.4%). No statistical significance between pre- and postoperative angulation correlated to fracture patterns or diameter of the elastic nail was seen. As expected, there was a significant improvement of postoperative angulation. Using radial approach in distal radial fractures showed a lower rate of surgical related complications, 2.3% of which need further surgical treatment as well as better postoperative angulations compared to the dorsal approach (8.5%). Conclusion: Especially due to the low risk of damaging the EPL tendon, the radial approach showed a lower complication rate which needed further surgical treatment. The risk of lesions of the superficial radial nerve remains.

The Current Safety Regulation for Radiation Emergency Medicine in Korea

Radiation emergency medicine (REM) systems are operated around the world to provide specialized care for injured individuals who require immediate medical attention in accidents. This manuscript describes the current status of REM safety regulation in Korea and summarizes an assessment of the effects of this regulation. Responding to the requests of people for stronger safety regulations related to radiation exposure, a unique REM safety regulation for nuclear licensees, which is enforceable by laws, has been established and implemented. It is not found in other countries. It can provide a good example in practice for sustainable REM management including document reviews on medical response procedures and inspections of equipment and facilities. REM preparedness of nuclear or radiologic facilities has been improved with systematic implementation of processes contained in the regulation. In particular, the medical care system of licensees has become firmly coordinated in the REM network at the national level, which has enhanced their abilities by providing adequate medical personnel and facilities. This legal regulation service has contributed to preparing the actual medical emergency response for unexpected accidents and should ultimately secure the occupational safety for workers in radiation facilities.