Lung dose rate and interstitial pneumonitis in total body irradiation for bone marrow transplantation

The effect of dose rate to the lungs and development of interstitial pneumonitis (IP) was evaluated in 114 bone marrow transplant patients receiving fractionated total body irradiation (TBI) (1200 rads TD in 6 fractions twice daily over 3 days) as part of their pre-conditioning regimen. The tumour dose (TD) was calculated as the mean lung dose as previously described (1). A 6MV linear accelerator at a mid-line dose rate of 7.5 rads/minute was used between March 1981 and June 1985 and a Co-60 source at 5 rads/minute thereafter. This resulted in a range of dose rates to the lung of between 6.9 and 8.9 rads/minute and 2.9 and 6.5 rads/minute respectively. In the majority of patients the aetiology of IP was investigated by lung biopsy with histology and culture. There was no statistically significant difference in the incidence of IP over the two sets of dose rates. Our study suggests tat the incidence of IP using fractionated TBI is not influenced by dose rates below 8.9 rads per minute.     

STUDY OF AN OUTBREAK OF SCURVY I. CLINICAL FEATURES

During the fall of 1935, CheeIoo University Medical SchooL accepted responsibility for the medical care of 19,000 refugees from the flooded farming districts of south-western Shantung, They were cared for in Tsinan at govemment expense, in 30 groups or "camps", of from 200 t0 1,400 persons each, and were provided with two meals a day, consisting of steamed bread, made of 4th grade wheat flour and millet flour, a thin millet congee and pieces of salt turnip. Many individuals supplemented this diet from time to time with small quantities of vegetables, such as raw onion, red pepper sauce and boiled caloloage bought from vendors. This was more common in the early fall than later in the winter, when their small private funds had, in many cases, been exhausted. Later in the winter, the ingredients of the bread were changed to include corn meal, 4th class wheat flour and millet flour.