Green Book Biophysics Questions (paper 2)

1-March 1997 q. 36
(1)In experimental conditions, ultrasound may produce biological effects on tissues by the
following means:
 Acceleration of cell division
 Heat generation
 Cavitation
 Duplication of chromosome numbers
 Microstreaming

FTTFT

Mechanical effects of ultrasound are not thought to affect cell structure or chromosomes.
Vibration can cause small cavities in the suction phase, which disperse in the pressure phase. In
gas-free fluids these are called cavities, and in fluids containing gas they are called
pseudocavities. High intesnsity ultrasound may cause heat production. At diagnostic levels this
is dispersed but at therapeutic levels this heat may be used. Experimentally ultrasounds can
break down polypeptides and polysaccharides, including DNA. They can also cause oxidation
and reduction. High intensity and frequency ultrasound may cause tissue necrosis,
chromosomal damage, genetic mutations and teratogentic changes. Microstreaming may alter
cell membrane structure, function and permeability, which has been suggested to stimulate
tissue repair. Effects of cavitation and microstreaming that have been demonstrated in vitro
include stimulation of fibroblast repair and collagen synthesis, tissue regeneration and bone
healing.

2-March 1997 q. 37, March 2001 q. 16

(2)Concerning radiation physics:
 An electron has a greater mass than a proton
 A positron has the same charge as an electron
 A proton has a positive charge
 A neutron has the same mass as a proton
 The hydrogen nucleus is a neutron

FFTTF

Protons carry one positive charge and neutrons carry no charge. α-particles are 2-plus-2 groups
of protons and neutrons. Electrons are called β-particles and electrons with a positive charge
are called positrons. Protons and neutrons each have about 2000x the electron mass. Therefore
α-particles have about 8000x electron mass. The hydrogen nucleus contains a single proton.

3-September 1997 q. 15, March 2000 q. 18

(3)The ultrasound energy used in real-time machine for diagnostic imaging:
 Is pulsed
 Has a velocity measured in metres per second
 Has a velocity which is the same as human tissues
 Has a frequency measured in decibels
 Is entirely dissipated in tissue

TTFFF
Mechanical vibrations at frequencies above 20 kHz are defines as ultrasound. For medical
imaging the frequencies used are 3-15 MHz. reflected echoes produced within the body are
detected and displayed. The speed of sound in most tissues is similar and close to that of water.
All ultrasound scanners are set up assuming that the speed of sound in all tissues is 1540 m/s.
The ultrasound is generated by a transducer (which is also the receiver) and sent out in pulses.
Each pulse is responsible for the generation of several echoes – those from deeper tissues will
have to travel further so will take longer to return to the receiver. The speed of sound in the
material is c and the depth of the interface is D. The time, T, for the pulse to travel from the
transducer to the interface and back is T=2D/c.

4-September 1997 q. 16, September 2001 q. 16

(4)The natural decay of radioactive isotopes results in emission of:
 Alpha particles
 Gamma rays
 Neutron rays
 Proton beams
 Beta particles

TTFFT

When the nucleus of a radioactive isotope gives up its extra energy, that energy is called ionizing
radiation. Ionizing radiation may take the form of alpha particles, beta particles, or gamma
rays. Ionizing radiation is of concern because it may cause adverse health effects. The process of
emitting the radiation is called radioactive decay.

5-March 1998 q. 16
(5)Radiation damage to tissues:
 Is greatest in a tissue with a high mitotic index
 Is enhanced in the presence of reduced oxygen tension
 May cause non-specific inflammatory response
 Does not cause neoplasia
 May cause chromosomal non-disjunction

TFTFT

The radiation energy causes the damage – if radiation passes straight through a tissue without
giving up any energy it will not do any damage. The quality factor (QF) indicated how much
damage a particle will do – α particles are the most damaging. Low energy particles cause
greater damage because they have less ability to pass through tissue hence tend to dissipate their
effects in the tissue. The most susceptible tissues are blood cells (immature), gonads (rapidly
divising), eye lens (no cell replacement) and nerve cells (no cell replacement).

A dose of one millisievert corresponds to a chance of 6 in 100,000 of contracting a cancer. This

figure can be compared with the normal incidence of cancer which is 25,000 cases per 100,000
over a lifetime. Radiation therapy is used to treat some cancers, keloid scarring and pterygima,
for instance.

General inflammation may occur as a side effect, causing swelling that responds to steroids.
Radiation therapy works by damaging cell DNA, either directly or indirectly. Indirectly it does
this by ionizing water to form free radicals (usually hydroxyl radicals), which then damage the
DNA. Oxygen ‘fixes’ the radiation damage to DNA so reduced oxygen tension reduces the
effectiveness of radiation treatment. Rapidly dividing cells show radiation damage effects at
lower radiation doses.

6-March 1999 q. 15, September 2001 q. 17

(6)In radiotherapy:
 1 Gray is equivalent to 1 joule per kilogram
 The skin usually receives a greater dose of radiation than the underlying tissues
 The major effect of radiation damage is to the cytoplasm of the cell
 Cells in tissues which are hypoxic are more vulnerable to radiation
 Radiation-induced changes in tissues may take 6 weeks to develop

TFFFT

Several beams are focused on the tumour from several different angles, so that the radiation
converges where it needs to be. This spares the surrounding skin to some extent. The radiation
acts on the DNA of the cell. Hypoxic cells are less vulnerable because oxygen ‘fixes’ radiation
damage to DNA. Radiation changes can be long term or short term.

7-September 1999 q. 17
(7)Doppler ultrasound:
 Is used to monitor fetal breathing
 Is used in fetal heart rate monitors
 Can be used to measure blood velocity in the fetus
 Measures proton relaxation times
 Requires injection of contrast agents

FTTFF

Doppler systems detect movement rather than distance. It measures the moving blood cell in
blood. Proton relaxation time is important in MRI.

8-September 2000 q. 17
(8)Concerning radiotherapy:
 A Gray (100 rad) is a unit of energy absorption
 Liver parenchyma is more radiosensitive than intestinal epithelium
 Cells with a slow reproductive capacity are usually the most radiosensitive
 The concentration of intracellular oxygen is inversely proportional to the susceptibility of
the cell to radiation damage
 Well-differentiated tumours show a higher radiosensitivity than anaplastic tumours

TFFFF

Absorbed dose is measured in Grays. Rapidly dividing cells show radiation changes at lower
doses. Hypoxic cells are less vulnerable because oxygen ‘fixes’ radiation damage to DNA.
Anaplastic means less well differentiated (more immature).

Dr.Dolieb Hassan
With Best Wishes