Evaluating the Radioactive Waste Produced per Patient by Radiopharmaceutical Sources and Measuring the Radioactive Contamination of Surfaces and Staff at the Bushehr Nuclear Medicine Department.

Background: Nuclear medicine is an integral and developing field in diagnosing and treating diseases. Monitoring individuals' protection and radiation contamination in the workplace is vital for preserving working environments. Objective: This study aimed to monitor the nuclear medicine department's personnel, environment, and wastes to determine the level of occupational radiation and environmental pollution in Bushehr's nuclear medicine department. Material and Methods: In this cross-sectional study, the initial activity of each radioisotope, radiopharmaceutical, and radioactive waste was measured using a "well counter" daily for three months. Three irradiators' absorbed doses were measured using a direct reading dosimeter. The contamination was determined using an indirect wipe test method on various surfaces. A Geiger Müller dosimeter was employed to examine personnel's hands, clothing, and footwear. Results: The highest activity was observed in technetium waste (1118.31 mCi). Every irradiator received a lower absorption dose than the International Commission on Radiological Protection (ICRP) standard threshold. The majority of contamination was associated with the exercise test room (0.04 Bq/cm2) and its work surface (0.013 Bq/cm2), which were both below the threshold (0.5 Bq/cm2). Staff monitoring indicated that two nurses (10 and 11 individuals) had the highest contamination rate (23.7%). Conclusion: Daily assessment of the type, activity, and method of radiopharmaceutical administration to the patient is advantageous for waste management. Surface contamination monitoring can significantly contribute to the estimation of the level of radiation pollution in the environment.

Investigating the Expression Levels of Bax and Bcl-2 Genes in Peripheral Blood Lymphocytes of Industrial Radiation Workers in the Asaluyeh Region.

Background: Industrial radiography uses gamma or X-ray radionuclide sources to investigate the safety of industrial materials. Industrial radiation workers receive the highest occupational radiation doses. Objective: The present study investigates the relationship between Bax and Bcl-2 gene expression variables in industrial radiation workers. Material and Methods: In this case-control study, data was collected using blood sampling from 40 workers, including two groups of non-radiation and radiation workers employed at the location. Expression levels of Bax and Bcl-2 genes were assessed in the laboratory. The environmental and absorbed doses of workers were measured using environmental and pen dosimeters. Results: Statistical analysis showed that the radiation group's Bcl-2 gene expression level was significantly higher. Findings also demonstrated a correlation between Bcl-2 gene expression and the number of workdays. Also, the Bax gene expression did not show a significant change, and the expression ratio of Bax/Bcl-2 was insignificant in the two groups. Conclusion: Exposure to low doses of radiation could promote an adaptive response in cells by increasing Bcl-2 gene expression.

Extremely Low Frequency-Electromagnetic Fields (ELF-EMF) Can Decrease Spermatocyte Count and Motility and Change Testicular Tissue.

Background: Substantial evidence indicates that exposure to extremely low frequency-electromagnetic fields (ELF-EMFs) affects male reproductive system. Objective: The goal of this study was to evaluate the effects of long-term irradiation with ELF-EMF on sperm quality and quantity and testicular structure. Material and Methods: In this case-control study, sixty male Sprague-Dawley rats were randomly divided into six groups. Experimental groups were exposed to ELF-EMF (50 Hz EMF, 100 µT) for either 1 h/day for 52 days (Group 1), 4 h/day for 52 days (Group 3), 1 h/day for 5 days (Group 5), 4 h/day for 52 days (Group 7). Groups 2, 4, 6 and 8 were only sham exposed at durations equal to Groups 1, 3, 5 and 7, respectively. Results: Both count and motility of sperms were significantly decreased in animals exposed to ELF-EMF (1 h/day for 52 days, 4 h/day for 52 day, and 4 h/day for 5 days) compared to the sham-exposed groups (P<0.05). Serum testosterone levels showed a significant decrease in the animals exposed to ELF-EMF (4 h/day for 5 days) compared to the control groups (P<0.05). A significant decrease was observed in the volume of the seminiferous tubules, seminiferous tubules epithelium and interstitial tissue in the animals exposed to ELF-EMF for 4 h/day for 5 days. Tubules length was also reduced by 18% in animals exposed to ELF-EMF (4 h/day for 5 days). Conclusion: Our results show that ELF-EMF can reduce spermatocyte count and motility and is able to induce structural changes in testicular tissue.

Hesperidin Modulates Troponin-1 Serum Level and Decrease Heart Tissue Injury of Irradiated Rats.

BACKGROUND: The heart is the major dose-limiting organ for radiotherapy of malignant tumor in the mediastanal region. OBJECTIVE: This study aims to investigate the radio protective effects of Hesperidin (HES) as a natural flavonoid after localized irradiation of the rat's mediastinum region. MATERIAL AND METHODS: In this experimental study, we divided sixty male rats into 4 groups (n=15). First group: Sham which received PBS; second group: Hesperidin only (100 mg/kg/day orally) for one week; third group: Radiation that received single dose of 20 Gy gamma radiation using Co-60 unit and the forth group: Radiation+HES that underwent the same dose of radiation and received HES for 7 days prior irradiation. Each group was divided in two branches. Early sampling from subgroup one was done 4-6 hours after irradiation to determine troponin-1 level changes. Rats of second subgroups were killed 56 days after irradiation for histopathological evidence. RESULTS: In radiation group, troponin -1 serum level had a significant increase in comparison with sham group (P<0.05). Histopathological evaluation of second subgroup showed there was a significant difference between sham and radiation group in some parameters. Inflammation (p=0.008), pericardial effusion (P=0.001), and vascular plaque (P=0.001) had an increase in the irradiation group. Oral administration of hesperidin significantly decreased all the above factors when was compared with irradiation group (P>0.016). CONCLUSION: Oral administration of Hesperidine for seven days prior radiotherapy may decrease troponin-1 and cardiac injury due to radiation.

Protection effect of cerium oxide nanoparticles against radiation-induced acute lung injuries in rats.

INTRODUCTION: Radiation therapy is one of the most common tools for treating cancer. The aim is to deliver adequate doses of radiation to kill cancer cells and the most challenging part during this procedure is to protect normal cells from radiation. One strategy is to use a radioprotector to spare normal tissues from ionizing radiation effects. Researchers have pursued cerium oxide nanoparticles as a therapeutic agent, due to its diverse characteristics, which include antioxidant properties, making it a potential radioprotector. MATERIALS AND METHODS: One hundred rats were divided into five groups of A) control group, intraperitoneal (IP) saline injection was done twice a week; B) bi-weekly IP injection of 14.5 nM (0.00001 mg/kg) CNP for two weeks; C) a single whole thorax radiation dose of 18 Gy; D) a single whole thorax radiation dose of 18 Gy + bi-weekly injection of 14.5 nM CNP for two weeks after radiation; E) bi-weekly IP injection of 14.5 nM CNP for two weeks prior to radiation + a single whole thorax radiation dose of 18 Gy. Thirty days after irradiation, 7 rats from each group were anesthetized and their lungs extracted for histopathological examination. RESULTS: Statistical analyses revealed that CNP significantly decreased the incidence of tissue collapse and neutrophile aggregation in rats receiving CNP before radiation in comparison with the radiation group. CONCLUSION: The results suggested the possibility of using CNP as a future radioprotector due to its ability to protect normal cells against radiation-induced damage.

Design and validation of a hospital emergency department preparedness questionnaire for radiation accidents, nuclear accidents, and nuclear terrorism in Iran.

BACKGROUND AND OBJECTIVES: Radiation accidents can cause numerous challenges to hospitals, the appropriate medical responses to which may save the lives of countless people. The present study aimed at the design and validation of an Emergency Department preparedness questionnaire for hospital emergency departments (EDs) in the case of radiation accidents, nuclear accidents, and nuclear terrorism in Iran. MATERIALS AND METHODS: This multistage cross-sectional study was conducted in 2019. The questionnaire items were created with the reference to article reviews and expert judgement. The validity of the questionnaire was assessed through face, content, and construct validities. Additionally, its reliability was estimated using measures of internal consistency and stability, namely Cronbach's alpha and intraclass correlation coefficient (ICC). To this end, the questionnaire was completed by the ED staff in the hospitals of Iran. RESULTS: The proposed 48-item questionnaire consisted of three themes: staff preparedness, stuff preparedness, and structure preparedness. The face and content validities were confirmed by expert judgement. All items remained with content validity ratio (CVR) > 0.7 and the mean content validity index (CVI) = 0.891. The overall Cronbach's alpha and ICC were 0.781 and 0.709, respectively for the whole questionnaire. CONCLUSION: Hospital ED preparedness in radiation and nuclear accidents requires readiness of staff, stuff, and structure of the ED, the consideration of which will properly respond to radiation and nuclear accidents. Thus, upstream organizations like the Ministry of Health and the Emergency Organization should oblige hospital EDs to make themselves be more prepared by codifying certain imperative laws and -policies.

Developing a Model for Hospitals' Emergency Department Preparedness in Radiation and Nuclear Incidents and Nuclear Terrorism in Iran.

OBJECTIVE: To develop a national model for hospitals' Emergency Department (ED) preparedness when facing radiation and nuclear incidents as well as nuclear terrorism in Iran. METHODS: This analytical study was carried out in 2019 via Delphi technique in two rounds and prioritization using a pairwise questionnaire. Using classic Delphi technique and pairwise comparison, the components were given to 32 specialists in emergency medicine, nuclear medicine, medical physics, nuclear physics, radiobiology and radiation protection, health in disaster and emergency, and passive defense. Finally, the national model was developed by holding two focus group sessions. RESULTS: The results from the two rounds of Delphi technique showed that 31 factors of preparedness were classified into three main classes, namely staff, stuff, and structure (system). Only three factors were excluded and the rest were agreed upon by the specialists. Given the weight of each class, it was found that staff preparedness and stuff preparedness had the highest and lowest priorities, respectively. CONCLUSION: Comprehensive preparedness requires enhancing and promoting cultural, social, economic, and political levels. Indeed, all preparedness levels should be promoted in alignment with each other. Hence, governments should align their policies to manage such incidents.

Evaluation of the effect of hesperidin on vascular endothelial growth factor gene expression in rat skin animal models following cobalt-60 gamma irradiation.

INTRODUCTION: Skin is highly prone to radiation damage. Radiation burn is defined as damage to the skin or other biological tissues induced by radiofrequency or ionizing radiation. Vascular endothelial growth factor (VEGF) is a heparin-binded pro-angiogenic factor. Flavonoids belong to a family of polyphenol chemical compounds that are frequently present in fruits and vegetables. Hesperidin is an agent belonging to the flavonoid family. The aim of this study is to investigate whether hesperidin can affect the VEGF gene expression in rat skin following gamma irradiation or not. MATERIALS AND METHODS: A total number of 36 male Sprague-Dawley rats were divided into three groups. First group: radiation group (n = 12), second group: radiation + hesperidin-treated group (n = 12), and third group: untreated control group (n = 12). The hesperidin administration dose was 100 mg/kg body weight. The rats received a 22 Gy single dose at a dose rate of about 0.3 Gy/min using a cobalt-60 external beam radiotherapy unit. The animals were euthanized 24 h postirradiation. VEGF gene expression data were analyzed using the equation 2-ΔΔCT, where ΔΔCT = (Threshold cycle [CT], of target gene - CT of housekeeping gene)treated group- (CT of target gene - CT of housekeeping gene)untreated control group. Glyceraldehyde-3-phosphate dehydrogenase gene was used as a housekeeping gene. RESULTS: VEGF gene in the radiation + hesperidin group overexpressed 25-fold relative to the control group. In addition, VEGF gene in the radiation group underexpressed 0.15-fold relative to the control group. When the three groups were compared relative to each other using the Kruskal-Wallis test, P < 0.001 was obtained. Based on the Mann-Whitney U-test, when all groups were compared to each in a binary model, P = 0.001 was achieved. These tests all showed statistically significant changes in VEGF gene expression. CONCLUSIONS: We can conclude that hesperidin is a potent angiogenic factor. Hesperidin as a radioprotector can initiate angiogenesis by VEGF gene induction. It may stimulate epithelialization, collagen deposition, and enhanced cellular proliferation. These changes can together accelerate wound healing, in particular, radiation-induced skin damage.

Expression of Bax and Bcl2 Genes in Peripheral Blood Lymphocytes of Patients with Differentiated Thyroid Cancer.

CONTEXT: Thyroid cancer is the most common endocrine malignancy worldwide. Iodine-131 is used in the treatment of thyroid cancer with dosage of 100 mCi. In the medical applications of ionizing radiation besides the advantages such as diagnosis and treatment of diseases, the risks arising from exposure should be considered as well. AIMS: The present study aimed to evaluate the changes in expression levels of apoptotic Bax and Bcl-2 and the ratio of Bax/Bcl-2, in the peripheral blood lymphocytes (PBLs) of patients with differentiated thyroid cancer (DTC). SETTINGS AND DESIGN: This study was conducted on fifty thyroid cancer patients who had undergone surgery and were under treatment with 100 and 150 mCi doses. Subjects and Methods: Blood samples were taken from the patients, one before iodine treatment and another 48 h after therapy. Bax and Bcl-2 gene expression levels were measured by using real-time reverse transcriptase polymerase chain reaction. STATISTICAL ANALYSIS USED: The data were analyzed using one-way analysis of variance followed by samples t-test and independent samples t-test. RESULTS: Significant changes were observed in the percentage of apoptotic cells, in groups, after radioiodine therapy compared with before treatment. The ratio of Bax/Bcl-2 in both groups showed a significant increase (P < 0.001). The relative expression level of Bax gene showed a significant increase in comparison with the control group. CONCLUSIONS: Iodine therapy reduced expression of Bcl-2 and a significant expression of Bax and finally increased the ratio of Bax/Bcl-2. Iodine therapy led to apoptosis in the PBLs of patients with DTC. Therefore, it can be suggested that this method can be useful for monitoring and detecting destructive effects of ionizing radiation in nuclear medicine patients.

Radioprotective effect of melatonin on the cervical spinal cord in irradiated rats.

OBJECTIVE: It has been suggested that the vascular endothelial growth factor (VEGF) gene expression plays an important role in radiation-induced injury to the spinal cord. This study assesses the radioprotective effects of N-acetyl-5-methoxytryptamine (melatonin) through its modulation of VEGF expression after localized irradiation of the cervical spinal cord. MATERIALS AND METHODS: In this experimental study, we divided 192 male rats into four groups: 1. control (n=48); 2. rats that received an intraperitoneal (IP) injection of melatonin (n=48); 3. rats that received an IP injection of melatonin 30 minutes prior to cervical spinal cord gamma irradiation [dose: 22 Gy; (n=48)]; and 4. rats that received an IP injection of vehicle prior to spinal cord irradiation (n=48). The changes in VEGF expression were assessed using real-time RT-PCR and enzyme-linked immunosorbent assays. Samples for light microscopy were stained with hematoxylin and eosin (H&E). The differences among the groups were analyzed using the analysis of variance (ANOVA) test followed by Tukey's multiple comparisons test. RESULTS: Up-regulation of VEGF expression was observed from 8 to 22 weeks after irradiation (p<0.05). Paralysis and other radiation-induced myelopathy manifestations developed within 22 weeks after irradiation. VEGF expression in the melatonin pre-treatment group significantly down-regulated in the 20(th) and 22(nd) weeks after irradiation compared to the radiation-only group. CONCLUSION: The results support the hypothesis that modulation of VEGF expression by melatonin administration may increase the survival rate of irradiated animals.